title: Minimal incision transinguinal repair for incarcerated obturator hernia.
abstract: BACKGROUND
  Patients with incarcerated obturator hernia are usually elderly, frail, and physically inactive women with serious comorbidities. Although a laparotomy is standard surgical intervention for emergency incarcerated or strangulated obturator hernia, it is invasive particularly for these high-risk patients. The aim of this study is to show the feasibility of minimum open inguinal approach to reduce surgical risk for preoperatively diagnosed incarcerated obturator hernia.
  
  
  METHODS
  Between April 2008 and July 2012, 3 consecutive incarcerated obturator hernia patients at Kamitsuga General Hospital who were diagnosed preoperatively by computed tomography underwent the following procedure. First a 4 cm inguinal hernia incision and preperitoneal dissection through the opening of the deep inguinal ring are made. The obturator hernia can be easily found 2 cm dorsally from the Cooper's ligament extraperitoneally. A small incision is made at medial sharp edge of the hernia defect. The hernia sac and its content can then be reduced. If the incarcerated bowel is viable, a prosthetic mesh is placed as a patch. If the bowel is necrotic, the damaged bowel loop is withdrawn through the wound and easily reconstructed extra-abdominally.
  
  
  RESULTS
  All operations were successfully completed with this procedure. All patients recovered without incident.
  
  
  CONCLUSIONS
  Minimal incision transinguinal repair for diagnosed incarcerated obturator hernia is feasible and provides an improved option to more invasive procedures.
authors: Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota-cho, Kanuma, Tochigi, Japan, tenriver@kamituga-hp.or.jp.
authors: Y
authors: Y
authors: Togawa
authors: T
authors: T
authors: Muronoi
authors: H
authors: H
authors: Kawaguchi
authors: T
authors: T
authors: Chiku
authors: W
authors: W
authors: Sano
authors: T
authors: T
authors: Hashiba
authors: A
authors: A
authors: Ueda
authors: K
authors: K
authors: Kaneoya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006553:Hernia, Obturator / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery; D007422:Intestines / Q000098:blood supply; D019060:Minimally Invasive Surgical Procedures; D013526:Surgical Mesh
references: Ann Surg. 2012 Jan;255(1):176-80
references: 21677561
references: Surg Endosc. 1996 Apr;10(4):437-8
references: 8661798
references: Hernia. 2009 Jun;13(3):313-5
references: 18956136
references: Surg Endosc. 2004 Jun;18(6):954-6
references: 15095078
references: Hernia. 2008 Apr;12(2):199-200
references: 17628737
references: World J Surg. 1999 Feb;23(2):214-6; discussion 217
references: 9880435
references: World J Surg. 2005 Apr;29(4):450-4; discussion 454
references: 15776293
references: Surg Today. 2009;39(9):821-4
references: 19779783
references: Hernia. 2012 Jun;16(3):315-9
references: 22138700
references: Int J Colorectal Dis. 2012 Feb;27(2):133-41
references: 21858452
references: World J Surg. 2011 Oct;35(10):2323-7
references: 21858557
references: Am J Surg. 2004 Apr;187(4):549-52
references: 15041510
references: Br Med J. 1919 Aug 2;2(3057):134-5
references: 20769564
references: Hernia. 2010 Aug;14(4):409-13
references: 20422238
references: Hernia. 2010 Apr;14(2):203-6
references: 19554389
references: Hernia. 2008 Jun;12(3):289-97
references: 18188503