Emergency laparoscopic repair for strangulated groin hernias: A single centre experience

Aim The aim of the present study was to evaluate the efficacy of laparoscopic management for strangulated groin hernias. Patients and Methods From January 2007 to December 2009, the perioperative and long-term results of a consecutive series of patients who underwent laparoscopic repair of strangulated groin hernia were retrospectively analysed. The demographic data of patients, types of hernia, levels of peritoneal contamination, details of surgical techniques, hernia contents, conversion rate, operation time, postoperative complications, follow-up time and recurrent rate were recorded. Results A total of 43 patients with strangulated groin hernia admitted via casualty during the study period were managed by the laparoscopic approach in our unit. We operated on 36 inguinal hernias, 10 femoral hernias and three obturator hernias; five of these were recurrent hernias, and six patients had concurrent groin hernias. We adopted a totally extraperitoneal (TEP) approach for 37 patients and the transabdominal preperitoneal (TAPP) approach for four patients with femoral hernias; two obturator hernias were repaired by board ligaments. None required conversion. One patient had a small perforation of the small bowel during reduction of hernia content, which was repaired primarily; the TEP approach was performed subsequently. None had postoperative infection. One patient had haematoma, and five patients had seroma; all were treated conservatively. The mean operation time was 75 min. The mean postoperative hospital stay was 3.5 days. For those younger than 60 years, the mean postoperative hospital stay was 1.7 days. The mean follow-up time was 14 months. There were no recurrences. Conclusion For selected patients, laparoscopic repair for strangulated groin hernias is safe and feasible, with a low rate of infection, complications and recurrence.