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Endo-laparoscopic approach for repair of femoral hernia in an Asian cohort

Sujith Wijerathne, Raquel Maia, Hrishikesh Salgaonkar, Wee Boon Tan, Lynette Loo, Davide Lomanto. National University Hospital, Singapore

Introduction: A femoral hernia is a less common type of hernia. It is estimated to account for less than 5% of all abdominal wall hernias. Only about 1 in every 20 groin hernias are femoral hernias. They are found more commonly in females due to wider shape of pelvis. Laparoscopy by offering magnification and better vision provides us the opportunity for clear visualization of the myopectineal orifice. Laparoscopy seems to be a safe and feasible approach for femoral hernia repair in an Asian population. 

Case Description: Between 2013 and 2016, 70 consecutive patients with femoral hernia who underwent laparoscopic hernia repair were prospectively studied. Patient demographics, hernia characteristics, operating time, conversion rate, intraoperative, postoperative complications and recurrence were measured.

Discussion: Total of 83 femoral hernias were repaired, 45 on right and 38 on left groin. This included 52 patients with bilateral and 18 unilateral hernia. 19 concomitant obturator hernia were found. There were 65 male and 5 female patient. No conversion was reported. One patient had injury to bowel at the 10mm port entry site, without contamination, identified and managed immediately. 10 patients developed seroma, all were managed conservatively except one who needed aspiration. Peri-port bruising was noticed in 3 patients and 2 patients had hematoma. One patient with hematoma underwent excision of the organised hematoma.1 of the hematoma patient was on aspirin pre-operatively. No wound infection, chronic groin pain or recurrence was documented during follow up till date. 

Conclusion: Laparoscopic repair offers accurate diagnosis and simultaneous treatment of both inguinal and femoral hernia with minimum morbidity and good clinical outcomes. Better visualisation and magnification gives us an opportunity to identify occult hernias which can be repaired during the same setting, thereby reducing the chance of recurrence and possible need for second surgery. Laparoscopic repair has become the procedure of choice for the treatment of the majority of groin hernia at our institution.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86294

Program Number: P035

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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