Endoscopic TEP inguinal hernia repair in the management of occult obturator and femoral hernias.
OBJECTIVE
The gold standard technique for the repair of groin hernias has always been a controversial issue. Richard Ger introduced the endoscopic approach for the repair of groin hernias in 1991.The endoscopic technique follows the basic principle of preperitoneal placement of a polypropylene mesh over the myopectineal orifice. During the course of dissection of the preperitoneal space, occult obturator and femoral hernias were discovered.


METHODS
Patients who underwent endoscopic totally extraperitoneal repair of inguinal hernias over a period of 2 years were included in this retrospective study.


RESULTS
A total of 305 cases of groin hernias were operated in 208 patients over a period of 2 years from January 2010 to January 2012 in a single institution. Eleven synchronous clinically occult obturator hernias were found in 8 patients (3.84%) and 5 synchronous clinically occult femoral hernias were found in 5 patients (2.40%) during repair.


CONCLUSIONS
Preoperative and perioperative findings were discordant in quite a few cases. Preperitoneal dissection discovered coincidental occult hernias in 6.25% of patients.
Institute of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital, New Delhi, India.
Alok
A
Rath
Parveen
P
Bhatia
Sudhir
S
Kalhan
Suviraj
S
John
Mukund
M
Khetan
Vivek
V
Bindal
Asfar
A
Ali
Rahul
R
Singh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006550:Hernia, Femoral / Q000150:complications / Q000601:surgery*; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006553:Hernia, Obturator / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult