V-054 LAPAROSCOPIC REPAIR OF TWO CASES WITH OBTURATOR HERNIA; EARLY DAIGNOSED AND SUCCESSFUL RESULTS

Abstract

Abstract Aim Obturator hernia is a rare type of groin site hernias. Early diagnosis may prevent intervention on gastrointestinal tract. In this report, we present two octogenarian female patients with early diagnosed obturator hernia. Material & Methods In first case, 83-year-old female admitted to the Emergency Room(ER) for her left groin site pain. Physical examination was unremarkable except mild tenderness on left groin site. There was no abdominal distention. Ultrasound was negative for surgical aspect. Computerized tomography(CT) scans revealed left sided obturator hernia. Laparoscopic trans abdominal pre-peritoneal (TAPP) repair was planned. Peritoneum was opened about 4–5 cm cranial side of the hernia defect and preperitoneal space was prepared. Cone-shaped 5×5 cm polypropylene mesh have placed in the obturator canal. Afterwards 15×15 cm polypropylene mesh was placed to the groin area, covering all possible hernia sites. The mesh was fixed by tuckers and the peritoneal defect was closed. Second case, 84-year-old female admitted to ER with left groin and knee. There was no sign of inguinal hernia on physical examinitation except mild tenderness on left groin site. CT proved the intestinal segment within the left-sided obturator hernia sac. TAPP repair with mesh plug was planned. Peritoneum was opened and previously prepared cone-shaped 15×15 cm polypropylene mesh have placed in the obturator canal and fixed by tuckers. The peritoneal defect was closed and operation completed. Results Both patients were discharged at postoperative day 2. 60 day-postoperative periods were uneventfull. Conclusion The most crucial factor affecting the results is timing of surgery in obturator hernia.