Hernia inguinal estrangulada operada por laparoscopia

Hernia estrangulada intervenida de urgencia por laparoscopia. Caso clínico publicado en revista internacional.

1.- PUBLICACIÓN INTERNACIONAL

Este mes de junio ha sido publicado en una revista internacional el articulo titulado : Total Extraperitoneal (TEP) Hernioplasty With Intestinal Resection Assisted by Laparoscopy for a Strangulated Richter Femoral Hernia.

En este trabajo se describe una nueva estrategia de tratamiento de las hernias inguinales incarceradas añadiendo la posiblidad de un abordaje minimanete invasivo al tratamiento de esta entidad. Se describe por primera vez la utilización de la laparoscopia en una Hernia inguinal incarcerada.

Abstract:

We describe the first clinical case of a total extraperitoneal hernioplasty combined with intestinal resection assisted by
laparoscopy for a strangulated Richter femoral hernia. The patient was a 94-year-old woman admitted to the emergency room with signs and symptoms of acute small bowel obstruction. Diagnosis of a strangulated left Richter femoral hernia was only possible during the initial exploratory laparoscopy. The extraperitoneal approach for mesh positioning was performed gaining access through an infraumbilical 12mm trocar incision, and assistance of two 5mm laparoscopic ports at the hipogastrium and right flank. Laparoscopy was resumed and segmental intestinal resection with primary
anastomosis was performed. The patient recovered without complications and was discharged home at the fourth postoperative day. The total extraperitoneal approach for acute hernia repair was successful in our particular case. However, factors such as laparoscopic surgical experience, careful patient selection, and correct preoperative diagnosis must be considered before studies in theemergency setting.

Conclusión:

The TEP approach for emergency hernioplasty completed with segmental bowel resection with laparoscopic assistance was successful in our patient with a strangulated left RFH, suggesting its use for emergency hernia repair. However, factors such as laparoscopic surgical experience, careful patient selection, and correct preoperative diagnosis must be considered before development of clinical studies evaluating this type of approach in this particular setting.

 

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articulo TEP


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