Laparoscopic approach to the management of incarcerated hernia of appendices epiploicae: report of two cases and review of the literature.

Appendices epiploicae may be involved in several intraabdominal pathologic processes, including occasional incarceration in hernias. This diagnosis is most frequently made intraoperatively. In addition to repair of the hernia, management includes a thorough evaluation of the involved appendage in terms of its viability. Any appendage found to be nonviable or of doubtful viability needs to be excised. Such evaluation and excision has traditionally required an open approach. Laparoscopy offers the advantage of a comparable evaluation of viability, the ability to excise the affected appendage if necessary, and a significantly lower morbidity. The requirement of general anesthesia and the need to generate a pneumoperitoneum may be limiting factors in patient selection.