title: A case of incarcerated femoral hernia with intestinal blood flow assessment by brightfield full-color near-infrared fluorescence camera: Report of a case.
abstract: BACKGROUND
  Indocyanine green (ICG) fluorescence has been reported for examining intestinal blood flow (IBF), but not in the case of bowel released from entrapment in a femoral hernia. We report the case of a patient with incarcerated obturator femoral hernia in whom the bowel was preserved after evaluation of IBF with ICG fluorescence using a brightfield full-color near-infrared fluorescence camera.
  
  
  METHODS
  A woman in her 60s was diagnosed with incarcerated femoral hernia and underwent surgery. Laparotomy was performed to reduce bowel incarceration via an anterior approach. The small bowel showed deep-red discoloration on gross evaluation, but intravenous injection of ICG revealed uniform fluorescence of the mesentery and bowel wall. This indicated an absence of irreversible ischemic changes to the bowel, so resection was not performed and a modified Kugel herniorrhaphy was performed. The patient showed a good postoperative course.
  
  
  CONCLUSIONS
  In herniorrhaphy with mesh, minimization of bowel resection is important for preventing postoperative infection of the mesh. In this case, ICG fluorescence with a near-infrared fluorescence camera was central to reducing bowel resection. ICG fluorescence may be useful for evaluating IBF in surgery for incarcerated femoral hernias.
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: systematic.ryu1121@gmail.com.
authors.forename: Shunjin
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: masashi@iuhw.ac.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: ohdaira@iuhw.ac.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ohdaira
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: nobuhiro_mihoko@hotmail.com.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsutsui
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: norinori_sculler@yahoo.co.jp.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: i_eisaku_ukasie@yahoo.co.jp.
authors.forename: Eisaku
authors.initials: E
authors.lastname: Ito
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: keigo_0613@yahoo.co.jp.
authors.forename: Keigo
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: yanagisawa@sasaki-hp.or.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: kitajima@iuhw.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochigi, 329-2763, Japan. Electronic address: yutaka@iuhw.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
keywords: Case report; Femoral hernia; ICG fluorescence; Incarcerated hernia