Yamamoto Masaaki, Takeno Atsushi, Toshiyama Reishi, Tokuyama Shinji, Kawai Kenji, Takahashi Yusuke, Sakai Kenji, Hama Naoki, Kato Takeshi, Hirao Motohiro
Department of Surgery, NHO Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-Ku, Osaka, 540-0006, Japan.
Surg Case Rep. 2024 Sep 11;10(1):215. doi: 10.1186/s40792-024-02017-2.
Laugier's hernia is a very rare atypical femoral hernia and is challenging to diagnose preoperatively. Herein, we report a rare case of inguinal and Laugier's hernias treated with laparoscopic transabdominal preperitoneal repair.
A 63-year-old man was admitted to our hospital with right groin swelling for 4 years. Computed tomography revealed an indirect inguinal hernia with protrusion of the small intestine. The preoperative diagnosis was right indirect inguinal hernia; Laugier's hernia was unknown. The patient underwent laparoscopic transabdominal preperitoneal repair. During the surgery, part of the perivesical adipose tissue penetrated the lacunar ligament. It was located medial to the typical site of a femoral hernia. Thus, Laugier's hernia was diagnosed. Finally, laparoscopic transabdominal preperitoneal repair was performed for Laugier's hernia and inguinal hernia. The postoperative course was good, without recurrence.
To our knowledge, this is the first reported case of inguinal and Laugier's hernia treated with laparoscopic transabdominal preperitoneal repair. Surgeons should be mindful that inguinal hernias can occur concurrently with other types of hernias, such as femoral hernias, including atypical variants like Laugier's hernia. Additionally, they should actively consider laparoscopic approaches such as transabdominal preperitoneal for femoral hernias. These approaches are beneficial for precise diagnosis, confirming the presence of other hernias, and simultaneously treating all coexisting inguinal hernias.
劳吉尔疝是一种非常罕见的非典型股疝，术前诊断具有挑战性。在此，我们报告一例罕见的腹股沟疝和劳吉尔疝采用腹腔镜经腹腹膜前修补术治疗的病例。
一名63岁男性因右侧腹股沟肿胀4年入院。计算机断层扫描显示为间接性腹股沟疝，伴有小肠突出。术前诊断为右侧间接性腹股沟疝；劳吉尔疝情况不明。患者接受了腹腔镜经腹腹膜前修补术。手术过程中，部分膀胱周围脂肪组织穿透陷窝韧带。其位于股疝典型部位的内侧。因此，诊断为劳吉尔疝。最后，对劳吉尔疝和腹股沟疝进行了腹腔镜经腹腹膜前修补术。术后恢复良好，无复发。
据我们所知，这是首例采用腹腔镜经腹腹膜前修补术治疗腹股沟疝和劳吉尔疝的病例报告。外科医生应注意腹股沟疝可能与其他类型的疝同时发生，如股疝，包括像劳吉尔疝这样的非典型变异型。此外，他们应积极考虑采用腹腔镜手术方法，如经腹腹膜前修补术治疗股疝。这些方法有利于精确诊断，确认其他疝的存在，并同时治疗所有并存的腹股沟疝。
