Efficacy of Laparoscopic Obturator Hernia Repair Limited to the Hernia Orifice: A Case Report

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  • 閉鎖孔ヘルニア嵌頓に対する緊急手術として腹腔鏡下に閉鎖孔のみのメッシュ修復術を施行した1例
  • ヘイサコウ ヘルニアカントン ニ タイスル キンキュウ シュジュツ ト シテ フククウキョウ カ ニ ヘイサコウ ノミ ノ メッシュ シュウフクジュツ オ シコウ シタ 1レイ

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<p>An 83–year–old woman was referred to our hospital for abdominal pain and vomiting. Abdominal CT revealed a right incarcerated obturator hernia and emergency operation was performed via a transabdominal laparoscopic approach. After repositioning the incarcerated small bowel by the water pressure method, we inverted the hernia sac and exposed the preperitoneal space by incising and stripping the peritoneum over the obturator foramen. A prosthetic mesh was placed over the hernia defect extraperitoneally, and the peritoneum was closed over the mesh with running sutures. The postoperative course was uneventful, with no recurrence. Although the main therapeutic modality for obturator hernia is surgery, no standard surgical method has been established yet. While some authors have recently reported total repair of the myopectineal orifice for incarcerated obturator hernia, the validity of this method has not yet been investigated in detail. We report a case of laparoscopic obturator hernia repair limited to the hernia orifice. This simple and safe procedure could be a very useful treatment option for elderly patients needing emergency surgery.</p>

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