title: Totally extra-peritoneal repair for acute incarcerated femoral hernia with intestinal obstruction.
abstract: BACKGROUND
  Femoral hernias frequently present with incarceration, resulting in obstruction and strangulation. Laparoscopic groin hernia repairs have been shown in the elective setting to be an effective alternative to open repair. Acute incarceration of groin hernia with obstruction, though previously seen as a relative contraindication, has been increasingly repaired with minimally invasive techniques, with the potential benefit of avoiding the morbidity associated with a laparotomy.
  We describe a case of an acutely incarcerated femoral hernia with intestinal obstruction that was repaired using the totally extra-peritoneal approach. A releasing incision was performed to facilitate reduction of hernia prior to mesh repair. Diagnostic laparoscopy through a separate incision was then performed.
  
  
  CONCLUSIONS
  This modification of the TEP repair technique for the acutely incarcerated and obstructed femoral hernia serves to minimise potential contamination by keeping the pre-peritoneal plane strictly separate from the intra-peritoneal space.
authors.affiliation: University Surgical Cluster, National University Health System, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Guowei
authors.initials: G
authors.lastname: Kim
authors.affiliation: Senior Consultant National University Hospital, Professor of Surgery National University of Singapore, Department of Surgery, Singapore.
authors.forename: Jimmy Bok
authors.initials: JB
authors.lastname: Yan So
authors.affiliation: University Surgical Cluster, National University Health System, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: cfsasim@nus.edu.sg.
authors.forename: Asim
authors.initials: A
authors.lastname: Shabbir
keywords: Case report; Femoral hernia; Incarcerated; Obstructed; Totally extra-peritoneal repair