PDF(Pubmed)
Abstract：
Femoral hernias have a high incarceration rate, often necessitating urgent surgical intervention. In this report, we present a safe and reproducible laparoscopic technique for incarcerated femoral hernias with bowel involvement, including repair. Between December 2022 and May 2023, three female patients with incarcerated femoral hernias underwent urgent laparoscopic surgery. All patients presented with abdominal pain and were diagnosed with small bowel incarceration using computed tomography. Under laparoscopy, we confirmed intestinal incarceration and performed a standard transabdominal preperitoneal approach to identify the hernia defects. The iliopubic tract on the abdominal side of the hernia defect was carefully dissected using an energy device to enlarge the hernia orifice. A spontaneous reduction of the incarcerated intestine was achieved. After confirming the absence of bowel perforation, mesh was placed to repair the hernia. Following peritoneal closure, the affected part of the intestine was extracorporeally resected and anastomosed. We performed this technique on three patients, all of whom were later discharged without complications. In conclusion, for incarcerated femoral hernias with bowel obstruction, laparoscopic partial division of the iliopubic tract enables an easy, safe, and reproducible approach to incarceration release and subsequent hernia repair.
摘要：
股疝有很高的嵌顿率,通常需要紧急手术干预。在这份报告中,我们提出了一种安全且可重复的腹腔镜技术，用于肠受累的嵌顿性股疝，包括修理。在2022年12月至2023年5月之间，三名女性嵌顿股疝患者接受了紧急腹腔镜手术。所有患者均出现腹痛，并使用计算机断层扫描诊断为小肠嵌顿。在腹腔镜下，我们证实了肠嵌顿,并进行了标准的经腹腹膜前入路以确定疝缺损.使用能量装置仔细解剖疝缺损腹侧的髂耻骨束，以扩大疝口。实现了嵌顿的肠的自发减少。在确认没有肠穿孔之后,放置网片修复疝气。腹膜闭合后,受影响的肠道部分被切除并吻合。我们对三名患者进行了这项技术，所有患者后来均出院,无并发症.总之,嵌顿性股疝合并肠梗阻,腹腔镜下髂耻骨束的部分分割使一个简单的，安全,和可重复的方法来释放嵌顿和随后的疝修复。
