Obturator hernias: A review of the laparoscopic approach.
BACKGROUND
Obturator hernias (OH) account for a rare presentation to the surgical unit usually associated with bowel obstruction and strangulation. The treatment of this condition is classical laparotomy with repair of the hernia and bowel resection, if deemed necessary; recently, the laparoscopic approach has been reported in literature. This review examines the existing evidence of the safety and effectiveness of the laparoscopic approach for the management of OH.


METHODS
We have conducted a systematic review of the cases reported in the literature between 1991 and 2009, using Medline with PubMed as the search engine, as well as Ovid, Embase, Cochrane Collaboration and Google Scholar databases to identify articles in English language reporting on laparoscopic management for the treatment of this condition.


RESULTS
A total of 17 articles reporting on 28 cases were found. We describe the pooled data for demographics, operative time, hospital stay, morbidities and method of repair. We also compare to the results of the laparoscopic repair of other types of hernias in the literature.


CONCLUSIONS
This approach was found to be a safe and effective approach for the repair of OH as compared to the classical open approach; however, its adoption as the gold standard needs further multicenter trials.
Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Praed Street, W2 1NY, UK.
Samer
S
Deeba
Sanjay
S
Purkayastha
Ara
A
Darzi
Emmanouil
E
Zacharakis