Novel laparoscopic methods for inguinal hernia post pelvic fracture: A case report
| Autor: | Hiroyuki Kayata, Hideaki Yakushiji, Koji Amano, Yusuke Tsunetoshi, Motohiko Yamada, Junichiro Yokota, Akihiro Usui, Masanori Kawamoto, Nobutaka Mukai, Koichi Inukai, Yasuki Nakata |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Modified intraperitoneal onlay mesh IPTR iliopubic tract repair medicine.medical_treatment mIPOM modified intraperitoneal onlay mesh technique Article Abdominal wall 03 medical and health sciences 0302 clinical medicine TAWH traumatic abdominal wall hernia Medicine Hernia Iliopubic tract repair Pelvic fracture TEP total extraperitoneal Pelvis business.industry CT computer tomography Inguinal hernia TAPP transabdominal preperitoneal medicine.disease Surgery OTA Orthopedic Trauma Association medicine.anatomical_structure 030220 oncology & carcinogenesis Seroma 030211 gastroenterology & hepatology business Inferior epigastric vessels |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2020.01.048 |
| Popis: | Highlights • Surgery in elderly patients with pelvic fracture are expected to rise in the future. • Surgery for inguinal hernia can be challenging due to extensive adhesion formation. • Effective novel laparoscopic methods used: laparoscopic IPTR and mIPOM approach. • Laparoscopic surgery useful in flexibility of surgical options (TAPP, IPTR, IPOM). Introduction Pelvic fractures can occur in minor injuries, such as falls, in the elderly. Extensive adhesion of preperitoneal space is common after pelvic fracture surgery; hence, surgical interventions for inguinal hernia may be challenging. We treated a case of inguinal hernia after pelvic fracture surgery, using novel laparoscopic methods: iliopubic tract repair (IPTR) and modified intraperitoneal onlay mesh (mIPOM) approach. Presentation of case This is the case of an elderly male with pelvic fracture. Open reduction and internal fixation were performed. Eighteen months after the procedure, a right inguinal bulge appeared, swelling increased, and he opted for surgery. We chose laparoscopic surgery to determine the status of the hernia and anatomy around the pelvis. He was diagnosed with an indirect inguinal hernia, and the inner inguinal ring was widely open. We chose the mIPOM approach and IPTR. He was discharged on day 3 post-operation. He developed a seroma after surgery, which disappeared after a month. Six months post-operation, no recurrence or neurologic pain observed. Discussion The transabdominal preperitoneal approach (TAPP) was initiated at first; however, the adhesion inside the inferior epigastric vessels was very strong, challenging to break into the preperitoneal space. We switched to the mIPOM method because the peritoneum was fragile and difficult to suture. Additionally, the internal ring was widely opened; hence, we proceeded with IPTR on confirmation that no tension on the abdominal wall was applied. Conclusions Laparoscopic surgery is useful in flexibility of surgical options, such as TAPP, IPTR, IPOM, in addition to hybrid conversion. |
| Databáze: | OpenAIRE |
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