An Observational Study of Latent Inguinal Hernias During Laparoscopic Surgery for Other Sites

Yuka Mine, Fumihiko Fujita, Daisuke Kawahara, Takehiro Mishima, Yasuhiro Torashima, Shinichiro Ito, Shigeki Minami, Kengo Kanetaka, Mitsuhisa Takatsuki, Tamotsu Kuroki, Susumu Eguchi Eguchi. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences.

Background: The incidence of inguinal hernia is reported to be approximately 1.5% in the Japanese population. The purpose of this study was to determine the rate of the patients who will develop a latent inguinal hernia.

Methods: During laparoscopic abdominal surgery other than for an inguinal hernia, we observed the area around the inguinal lesion from the intraabdominal space under laparoscopic view, and tried to evaluate the degree of their recessus at the lesion. The classification defined the recessus at Hesselbach’s triangle as follows, Grade 0: no recessus, Grade I: slight recessus with a visible bottom, Grade II: deep recessus with an invisible bottom, Grade III: other organ invaginated into the recessus, Grade IV: confirmed bulging on the body surface.

Results: From 2009 to 2011, forty-six patients were enrolled. There were 19 males (median age 73, 50-88) and 27 females (median age 70.5, 24-93). The recessus around the Hesselbach’s triangle were detected in 20 patients (43.5%). The lesions were as follows, 11 on the lateral side of the inferior epigastric artery (IFA), six on the internal side of the IFA, two at both sites and one was found at the femoral ring. By the grade classification of these inguinal hernias, 26 (57%) were Grade 0, 14 (30%) were Grade I, four (9%) were Grade II, one (2%) was Grade III and one (2%) was Grade IV.

Conclusion: This study showed that patients with asymptomatic latent groin hernias are present at a relatively high frequency in the Japanese population.

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