Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan.
Asian J Endosc Surg. 2022 Apr;15(2):328-334. doi: 10.1111/ases.13010. Epub 2021 Nov 8.
The laparoscopic approach for elective femoral herniorrhaphy is well established. However, femoral hernias often present as incarcerations and require emergency repair surgery, mainly using the open approach. This study aimed to retrospectively analyze the efficacy of the laparoscopic approach for incarcerated femoral hernias.
Data of patients who underwent emergency surgery for incarcerated femoral hernia between April 2016 and August 2021 were retrospectively analyzed. Laparoscopy was performed whenever possible; however, conversion to an open approach remained a fallback option for when laparoscopic repair was not possible. In laparoscopic repair, incarcerated femoral hernias reduced using traction, water pressure, and preperitoneal methods. Data of patients who underwent open repair and laparoscopy were then compared.
During the observation period, 20 patients underwent emergency surgery for incarcerated femoral hernia. Eleven patients subsequently underwent repair using a laparoscopic approach, and eight underwent repair using an open approach. Only one patient underwent intestinal resection without hernia repair due to perforated bowel. Operative time for laparoscopic repair was longer. Mesh repair was performed in 18 patients. Four patients each in the laparoscopic repair and open group required intestinal resection.
Incarcerated femoral hernias can be safely repaired using the laparoscopic approach.
择期股疝的腹腔镜手术方法已经成熟。然而，股疝常表现为嵌顿，需要紧急手术修复，主要采用开放手术。本研究旨在回顾性分析腹腔镜治疗嵌顿性股疝的疗效。
回顾性分析 2016 年 4 月至 2021 年 8 月期间因嵌顿性股疝而行急诊手术的患者数据。只要有可能，就采用腹腔镜手术；然而，如果无法进行腹腔镜修复，则仍可转为开放手术。在腹腔镜修复中，使用牵引、水压和腹膜前方法减少嵌顿性股疝。然后比较了行开放修复和腹腔镜修复的患者的数据。
在观察期间，有 20 名患者因嵌顿性股疝而行急诊手术。随后，11 名患者采用腹腔镜方法进行了修复，8 名患者采用了开放方法进行了修复。只有 1 名患者因肠穿孔而未进行疝修补术。腹腔镜修复的手术时间较长。18 名患者行网片修补术。腹腔镜修复组和开放组各有 4 名患者需要进行肠切除术。
嵌顿性股疝可以安全地采用腹腔镜方法进行修复。
