The neglected surgery - Hernioscopy - Maybe the best choice for strangulated groin hernias in the COVID-19 pandemic.

Abstract

Abstract Objective: Although due to the Covid-19 Pandemic, elective surgeries have been postponed worldwide, emergency operations cannot be delayed and are being performed. In general surgery practice, incarcerated / strangulated inguinal hernias have a prominent place among emergency surgeries. In 1% of these patients, the hernia content reduces spontaneously into the abdomen until the hernia sac is opened. It is imperative that these bowel segments be evaluated for possible intestinal necrosis. Methods: Patients who underwent emergency surgery and hernioscopy in the Sakarya Training and Research Hospital General Surgery Service due to incarcerated or strangled inguinal hernia during the period from March 2020 to October 2020 were included in the study. Hernioscopy procedure was performed using single-port and glove-port methods. For each patient, age, duration of complaints, comorbidities, hernia repair method, operation time, incarcerated organ, whether ischemia improved after reduction or whether resection was required, postoperative complications were recorded. Results: Hernioscopy was performed on ten patients due to strangled inguinal hernia during the eight months. While femoral hernia was detected in 2 patients, eight patients had an inguinal hernia. In 1 patient, bowel resection and anastomosis were performed with the transabdominal approach because the small intestine necrosis was detected during the hernioscopy procedure. Conclusion: The hernioscopy method, which is performed under spinal anesthesia, prevents unnecessary laparotomies and should be preferred more during the COVID-19 pandemic process in patients who are urgently operated for strangled inguinal hernia. Key words: Hernioscopy; Strangulated Hernia; COVID-19 Pandemic