Obturator hernia: laparoscopic diagnosis and repair.
OBJECTIVE
Review of international literature reveals eight reported cases of laparoscopic obturator hernia repair. Non-specific signs and symptoms make the diagnosis of an obturator hernia difficult. Laparoscopic intervention provides a minimally invasive method to simultaneously diagnose and repair these hernias.


METHODS
A 35 year old woman presented with lower abdominal pain, vaginal bleeding, and dyspareunia. During gynecological diagnostic laparoscopy, a pelvic floor hernia was suspected, and a general surgical evaluation was sought. At a subsequent laparoscopy, the diagnosis of a left direct inguinal and a right obturator hernia was made. Both were repaired laparoscopically with polypropylene mesh.


RESULTS
At follow-up at one and six weeks postoperatively, the patient's complaints of pain had completely resolved.


CONCLUSIONS
The diagnosis of obturator hernia is problematic. The usual presenting signs and symptoms are non-specific. Without conclusive historical or physical findings, laparoscopy is an excellent method for diagnosing obturator hernia. This entity, once diagnosed laparoscopically, can be repaired simultaneously via laparoscopic mesh technique.
Haith
L R
LR
Department of Surgery, Crozer-Chester Medical Center, Upland, Pennsylvania, USA.
Simeone
M R
MR
Reilly
K J
KJ
Patton
M L
ML
Moss
B E
BE
Shotwell
B A
BA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006553:Hernia, Obturator / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D016896:Treatment Outcome