obturator hernia repair
The surgery is initiated by administering a dose of anesthesia to relax the patient and to reduce the pain and discomfort. 40 Currently these rare defects represent only 005 to 14 of all hernias encountered by clinicians.
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Obturator hernias are approached abdominally and can be repaired laparoscopically.
. Furthermore with the technical progress in laparoscopic surgery transabdominal and extraperitoneal approaches are possible and have been described to be successful in obturator hernia repair 7 8. The mean duration from the appearance of symptoms to surgery was 75 days range 30365. Therefore it is recommended for older patients.
The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly thin women. If the hernia content is difficult to reduce incision of. The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia.
It is ideal for the contaminated case and in settings where mesh is not readily available. Neither of them had. The obturator hernia was first described at the Royal Academy of Sciences of Paris by Pierre Roland Arnaud de Ronsil in 1724.
The recurrence rate at 3 years after the initial obturator hernia surgery was 51 359 cases. Computed tomography of the abdomen and pelvis showed a fluid-filled segment of small intestine between the left obturator externus and pectineus muscles Figure 1. The usual presenting signs and symptoms are non-specific.
This surgical technique is also indicated for obturator hernias without perforation. Obturator hernia can be treated with Laparoscopic surgery. Kugel repair for obturator hernia can be performed by making a small suprainguinal incision and requires a short operating time.
Download figure Open in new tab. The patient recovered uneventfully. Obturator hernia is rare pelvic hernia difficult to diagnose clinically because of non specific symptoms and obscure physical findings.
Several methods of dealing with the hernial defect have been described. Both patients presented with clinical and radiological signs of small bowel obstruction. This entity once diagnosed laparoscopically can be repaired simultaneously via laparoscopic mesh technique.
They can be repaired either transabdominally or extraperitoneally by the conventional open method or a laparoscopic approach. The diagnosis of obturator hernia is problematic. There appears to be no consensus on the ideal approach and repair for such a condition.
Two cases of obturator hernias in nonagenarians are reported and a new simple. Without conclusive historical or physical findings laparoscopy is an excellent method for diagnosing obturator hernia. Furthermore Kugel repair can still be performed for obturator hernias that require intestinal resection.
Obturator hernia is thought to result from progressive relaxation of the pelvic floor which may be associated with advanced age emaciation increased intraabdominal pressure and multiparity. Surgery video of 84 years old female patientShe underwent laparoscopic obturator hernia repairSurgeon. By the transabdominal.
Delayed diagnosis frequent complications leads to significant mortality. 4147 An obturator hernia occurs when intraabdominal viscera or. Similarly we found that obturator hernia was present in 13 126 of the 1028 patients who underwent surgical repair of abdominal wall hernia.
This surgical technique is also indicated for obturator hernias without perforation. The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia. Therefore it is recommended for older patients.
Use of computerised tomography in diagnosis and early repair either suture based or mesh placement depending on circumstances is. The surgeon then makes a small incision in the abdominal wall and inserts a laparoscope to view inside of the abdominal cavity and associated organs. We report a case of obturator hernia.
In our case the transabdominal TAPP approach was chosen because of clinical and radiographic signs of incarceration. Obturator hernias are rare and most cases present as incarcerated hernias. We report a simple quick technique via a lower midline incision using an autogenous peritoneal fold.
HK Ha Choongang Univ. 39 More than 100 years later Obre performed the first successful repair. We made a diagnosis of obturator hernia and performed emergency surgery using an inguinal approach.
Kugel repair for obturator hernia can be performed by making a small suprainguinal incision and requires a short operating time. Although several techniques of obturator hernia repair have been described surgical repair has not been standardized. The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly thin women.
The inguinal approach was selected and primary repaired with mesh in 14 operations 100. Both patients presented with clinical and radiological signs of small bowel obstruction. We report our technique of transabdominal laparoscopic direct repair using a running barbed suture in 2 cases.
Furthermore Kugel repair can still be performed for obturator hernias that require intestinal resection. Obturator hernia is a rare condition with few reports in the world literature.
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