A new technique of laparoscopic obturator hernia repair: report of a case

Surg Today. 1998;28(6):652-6. doi: 10.1007/s005950050201.

Abstract

An 84-year-old woman presented with ileus. Ultrasonography, a computed tomography scan, and small bowel contrast examination showed a Richter-type hernia in her left obturator orifice. Under general anesthesia, laparoscopic surgery with low-pressure (4mmHg) pneumoperitoneum was carried out using a peritoneal needle retractor, and a reduction of the strangulated intestinal loop was thus achieved. Because the hernial opening measured 5mm in diameter, it could be closed with four pieces of End-Universal stapler without polypropylene mesh. The ischemic ileum was resected, and the bowel was anastomosed extracorporeally with a minimal skin incision. She was ambulant on the first postoperative day, and her postoperative course was good. Obturator hernias are rare, but when a definitive diagnosis is made in such elderly patients, laparoscopic repair using the peritoneal needle retractor is recommended for minimally invasive surgery. We recommend doing the repair with an End-Universal stapler, since this procedure is more simple and useful for preventing infection than using polypropylene mesh in such a strangulated case.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hernia, Obturator / complications
  • Hernia, Obturator / surgery*
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery
  • Laparoscopes
  • Laparoscopy / methods*
  • Surgical Stapling