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The feasibility of laparoscopic management of incarcerated obturator hernia

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Abstract

Background

Obturator hernia (OH), a rare cause of acute small bowel obstruction, requires immediate surgical intervention to prevent serious complications and mortality. We assessed the safety and efficacy of laparoscopic surgery in patients with incarcerated OH presenting with acute abdomen in an emergency setting.

Methods

Data pertaining to patients diagnosed with incarcerated OH between 2011 and April 2015 at our hospital were reviewed. Patients’ characteristics, operation details and postoperative outcomes were retrospectively analyzed.

Results

All ten patients diagnosed with incarcerated obturator hernia during the reference period were females (average age 72.1 ± 11.8 years; average weight 44.1 ± 6.9 kg; average body mass index 17.8 ± 2.1 kg/m2; average operating time 63 ± 15 min; average hospital stay 6.2 ± 6.6 days). Twelve occult hernias, including six contralateral OHs, two ipsilateral femoral hernias and two bilateral femoral hernias were detected in six patients (60 %), which were simultaneously repaired after laparoscopic exploration. Nine patients (90 %) were successfully treated with synthetic mesh by laparoscopic technique. Only one case required intraoperative conversion to open surgery due to strangulated intestine with perforation. Wound infection was reported in one patient who had undergone bowel resection, but with an eventual complete recovery. Postoperative period was uneventful in the other nine patients. No recurrence or complications were reported on follow-up (mean duration of follow-up: 6–54 months).

Conclusion

In this study, laparoscopic technique was associated with a reduced duration of hospital stay and fewer complications. In addition to being a safe and minimally invasive strategy, it allowed for simultaneous diagnosis and treatment of occult hernias during the same procedure. The approach may be a better option for the treatment of incarcerated OH and occult hernias in selected patients.

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References

  1. Mantoo SK, Mak K, Tan TJ (2009) Obturator hernia: diagnosis and treatment in the modern era. Singap Med J 50(9):866–870

    CAS  Google Scholar 

  2. Lo CY, Lorentz TG, Lau PW (1994) Obturator hernia presenting as small bowel obstruction. Am J Surg 167(4):396–398

    Article  CAS  PubMed  Google Scholar 

  3. Yokoyama Y, Yamaguchi A, Isogai M, Hori A, Kaneoka Y (1999) Thirty-six cases of obturator hernia: does computed tomography contribute to postoperative outcome? World J Surg 23(2):214–216 discussion 217

    Article  CAS  PubMed  Google Scholar 

  4. Haraguchi M, Matsuo S, Kanetaka K, Tokai H, Azuma T, Yamaguchi S, Kanematsu T (2007) Obturator hernia in an ageing society. Ann Acad Med Singap 36(6):413–415

    PubMed  Google Scholar 

  5. Kammori M, Mafune K, Hirashima T, Kawahara M, Hashimoto M, Ogawa T, Ohta H, Hashimoto H, Kaminishi M (2004) Forty-three cases of obturator hernia. Am J Surg 187(4):549–552. doi:10.1016/j.amjsurg.2003.12.041

    Article  PubMed  Google Scholar 

  6. Ng DC, Tung KL, Tang CN, Li MK (2014) Fifteen-year experience in managing obturator hernia: from open to laparoscopic approach. Hernia 18(3):381–386. doi:10.1007/s10029-013-1080-0

    Article  CAS  PubMed  Google Scholar 

  7. Hayama S, Ohtaka K, Takahashi Y, Ichimura T, Senmaru N, Hirano S (2015) Laparoscopic reduction and repair for incarcerated obturator hernia: comparison with open surgery. Hernia 19(5):809–814. doi:10.1007/s10029-014-1328-3

    Article  CAS  PubMed  Google Scholar 

  8. Liu WY, Liu XH (2015) Laparoscopic technique in treatment of obturator hernia. China J Hernia Abdom Wall Surg (Electronic Edition) 9(3):261–262

    CAS  Google Scholar 

  9. Francis WW (1995) Obturator hernia needs a laparotomy, not a diagnosis. Am J Surg 170(3):309

    Article  CAS  PubMed  Google Scholar 

  10. Dundamadappa SK, Tsou IY, Goh JS (2006) Clinics in diagnostic imaging (107). Singap Med J 47(1):89–94 quiz 95

    CAS  Google Scholar 

  11. Nasir BS, Zendejas B, Ali SM, Groenewald CB, Heller SF, Farley DR (2012) Obturator hernia: the Mayo Clinic experience. Hernia 16(3):315–319. doi:10.1007/s10029-011-0895-9

    Article  CAS  PubMed  Google Scholar 

  12. Katoh T, Kawamoto R, Kusunoki T (2011) A case of obturator hernia with overlooked Howship-Romberg sign and treated as sciatica. Nihon Ronen Igakkai Zasshi 48(2):176–179

    Article  PubMed  Google Scholar 

  13. Nakayama T, Kobayashi S, Shiraishi K, Nishiumi T, Mori S, Isobe K, Furuta Y (2002) Diagnosis and treatment of obturator hernia. Keio J Med 51(3):129–132

    Article  PubMed  Google Scholar 

  14. Shapiro K, Patel S, Choy C, Chaudry G, Khalil S, Ferzli G (2004) Totally extraperitoneal repair of obturator hernia. Surg Endosc 18(6):954–956. doi:10.1007/s00464-003-8212-z

    Article  CAS  PubMed  Google Scholar 

  15. Jayant K, Agarwal R, Agarwal S (2014) Richter type of incarcerated obturator hernia; misery still continues. Pol Przegl Chir 86(10):490–492. doi:10.2478/pjs-2014-0087

    Google Scholar 

  16. Kohi S, Sato N, Mori Y, Uehara T, Tamura T, Minagawa N, Torigoe T, Shibao K, Higure A, Yamaguchi K (2013) A review of 13 cases of obturator hernia. J uoeh 35(4):273–277

    Article  PubMed  Google Scholar 

  17. Khaladkar SM, Kamal A, Garg S, Kamal V (2014) Bilateral obturator hernia diagnosed by computed tomography: a case report with review of the literature. Radiol Res Pract 2014:625873. doi:10.1155/2014/625873

    PubMed  PubMed Central  Google Scholar 

  18. Hodgins N, Cieplucha K, Conneally P, Ghareeb E (2013) Obturator hernia: a case report and review of the literature. Int J Surg Case Rep 4(10):889–892. doi:10.1016/j.ijscr.2013.07.012

    Article  PubMed  PubMed Central  Google Scholar 

  19. Haith LR Jr, Simeone MR, Reilly KJ, Patton ML, Moss BE, Shotwell BA (1998) Obturator hernia: laparoscopic diagnosis and repair. Jsls 2(2):191–193

    PubMed  PubMed Central  Google Scholar 

  20. Hunt L, Morrison C, Lengyel J, Sagar P (2009) Laparoscopic management of an obstructed obturator hernia: should laparoscopic assessment be the default option? Hernia 13(3):313–315. doi:10.1007/s10029-008-0438-1

    Article  CAS  PubMed  Google Scholar 

  21. Lynch NP, Corrigan MA, Kearney DE, Andrews EJ (2013) Successful laparoscopic management of an incarcerated obturator hernia. J Surg Case Rep. doi:10.1093/jscr/rjt050

    PubMed  PubMed Central  Google Scholar 

  22. Ramser M, Messmer AS, Zbinden I, Von Holzen U, Nebiker CA (2014) Incarcerated obturator hernia-laparoscopic repair with intraoperative view of the corona mortis. J Surg Case Rep. doi:10.1093/jscr/rju081

    PubMed  PubMed Central  Google Scholar 

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    Authors and Affiliations

    1. Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100043, China

      Jing Liu, Yilin Zhu, Yingmo Shen, Sujun Liu, Minggang Wang, Xuefei zhao, Yusheng Nie & Jie Chen

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    1. Jing Liu
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    2. Yilin Zhu
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    3. Yingmo Shen
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    4. Sujun Liu
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    Correspondence to Jie Chen.

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    Drs. Jing Liu, Yilin Zhu, Yingmo Shen, Sujun Liu, Minggang Wang, Xuefei Zhao, Yusheng Nie and Jie Chen have no conflicts of interest or financial ties to disclose.

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    Jing Liu and Yilin Zhu have contributed equally to this work

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    Liu, J., Zhu, Y., Shen, Y. et al. The feasibility of laparoscopic management of incarcerated obturator hernia. Surg Endosc 31, 656–660 (2017). https://doi.org/10.1007/s00464-016-5016-5

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