title: Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.
abstract: BACKGROUND
  During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair.
  
  
  METHODS
  This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly.
  
  
  RESULTS
  There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P < 0.001). None of the femoral hernias were clinically detectable preoperatively.
  
  
  CONCLUSIONS
  Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.
authors.affiliation: Department of Surgery, Bankstown-Lidcombe Hospital, Eldridge Road, Bankstown, NSW 2200, Australia. soniputnis@hotmail.com
authors.forename: Soni
authors.initials: S
authors.lastname: Putnis
authors.forename: April
authors.initials: A
authors.lastname: Wong
authors.forename: Christophe
authors.initials: C
authors.lastname: Berney
mesh_terms: D017558:Elective Surgical Procedures; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006550:Hernia, Femoral / Q000150:complications / Q000175:diagnosis*; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors