Abstract
Minimal access surgery or laparoscopic surgery has revolutionized the surgical world since its introduction in the 1980s. The evidence for elective laparoscopic groin hernia repair is well established. However, there are only handfuls of literatures on the evidence of emergency laparoscopic groin hernia repairs. In this review article we delineated details on how laparoscopy in emergency incarcerated or strangulated inguinal hernia repair benefits patients, and surgical technique and special precaution required during the operation. During open surgery surgeon to idle for 10–20 min trying to make a return on the bowel condition to prepare for bowel resection, and since its emergency condition and time essence for the surgeon so most of the time, surgeon would just proceed for bowel resection. Whereas, laparoscopic surgery allows ample time for the strangulated bowel to recover, and this in fact will avoid unnecessary laparotomy and bowel resection since most of the time the strangulated bowel can recovered if it allowed enough time for them to revascularize. In conclusion, laparoscopic approach for incarcerated or strangulated inguinal emergency hernias repair has its benefits in several areas over minimal access surgery which contribute to the improvement in clinical outcomes. However, careful selection of patients and a sufficient knowledge of anatomy and expertise in the reduction of the strangulated organs are required.
Highlights
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles
Incarcerated hernia: If the contents of the hernia become trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas
The findings of this study revealed that the operation time of laparoscopic surgery with the transabdominal preperitoneal repair (TAPP) approach was longer than the open surgical approach but with fewer complications and a shorter postoperative stay
Summary
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. It has the advantages of accurate diagnosis of the involved hernia, detection of any concurrent ipsilateral and contralateral hernias, smaller wound with less pain, significant lower surgical site infection rate, faster recovery and superior mesh placement which allow coverage for all potential myopectineal orifices. Some series had reported totally laparoscopic intra-corporeal bowel resection and anastomosis.[22] In an another retrospective study reported by Song et al involving 27 patients having strangulated inguinal hernia, comparing on laparoscopic versus open tension-free repair.[30] Their findings revealed that laparoscopic group has shorter operative time; lower complication rates on seroma, haematoma, and wound infection; faster return of bowel function; and shorter hospital stay. Authors have concluded that that laparoscopic surgery was a useful technique in emergent situations.[32]
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