Song Hong-Xia, Xie Tian-Hao, Fu Yan, Jin Xiao-Shi, Wang Qiang, Niu Zheng
Department of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Front Med (Lausanne). 2025 Aug 21;12:1643775. doi: 10.3389/fmed.2025.1643775. eCollection 2025.
De Garengeot hernia, characterized by appendiceal incarceration within a femoral canal hernia sac, is a rare condition with high risks of strangulation. Traditional open repair remains standard, but laparoscopic approaches offer minimally invasive alternatives. However, limited evidence exists on combining laparoscopic transabdominal preperitoneal (TAPP) with biologic mesh for this condition. This study presents a case of laparoscopic TAPP with biologic mesh for De Garengeot hernia with concomitant laparoscopic appendectomy. A 69-year-old woman presented with a right inguinal mass and pain. Imaging confirmed a femoral hernia containing the inflamed appendix. Laparoscopic exploration revealed ischemic appendiceal changes, necessitating appendectomy. Laparoscopic TAPP with biologic mesh was performed, utilizing keyhole fixation and reinforced closure. Postoperative recovery was uneventful, as evidenced by no recurrence at 18-month follow-up. Laparoscopic TAPP with biologic mesh represents a feasible, minimally invasive strategy for De Garengeot hernia, enabling simultaneous appendectomy and hernia repair. This approach leverages the regenerative properties of biologic scaffolds and their superior anti-infective properties, while minimizing complications, offering a promising alternative to traditional methods. Further research is needed to establish standardized protocols and assess long-term outcomes.
德加伦若疝以阑尾嵌顿于股管疝囊内为特征，是一种绞窄风险高的罕见病症。传统开放修复仍是标准术式，但腹腔镜手术提供了微创替代方案。然而，关于腹腔镜经腹腹膜前修补术（TAPP）联合生物补片治疗这种病症的证据有限。本研究报告了一例采用生物补片的腹腔镜TAPP治疗德加伦若疝并同期行腹腔镜阑尾切除术的病例。一名69岁女性因右侧腹股沟肿物及疼痛就诊。影像学检查证实为股疝，疝内容物为发炎的阑尾。腹腔镜探查发现阑尾有缺血改变，需行阑尾切除术。采用锁孔固定和加强缝合进行了腹腔镜TAPP联合生物补片修补术。术后恢复顺利，18个月随访未发现复发。采用生物补片的腹腔镜TAPP是治疗德加伦若疝的一种可行的微创策略，能够同时进行阑尾切除和疝修补。这种方法利用了生物支架的再生特性及其卓越的抗感染特性，同时将并发症降至最低，为传统方法提供了一种有前景的替代方案。需要进一步研究以建立标准化方案并评估长期疗效。
