Michael B Goldberg, MD1, Jessica Barton, DO2. 1Crozer-Keystone Health System, 2Philadelphia College of Osteopathic Medicine
Inguinal hernia repair is one of the most commonly performed procedures in the United States. The totally extraperitoneal (TEP) approach is a widely accepted laparoscopic technique. We report the case of a laparoscopic bilateral inguinal hernia repair after femoral-femoral bypass. The patient is a 76-year-old man with history of a femoral-femoral bypass for claudication who presented with a symptomatic, enlarging left groin hernia in the region of his bypass. On exam, he had a reducible left inguinal hernia underneath a palpable vascular graft. Computed tomography scan revealed the graft above the rectus muscle with bilateral inguinal hernias in very close proximity. Totally extraperitoneal laparoscopic inguinal hernia repair was chosen as an open incision would directly interfere with the graft. The preperitoneal space was successfully dissected and additional ports were placed without disrupting the graft. Bilateral hernias were reduced and repaired with mesh using the TEP approach. The patient experienced no postoperative complications. In conclusion, laparoscopic totally extraperitoneal inguinal hernia repair is feasible for patients with extra-anatomic vascular bypass grafts in the inguinal region.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94245
Program Number: V359
Presentation Session: Video Loop Day 4
Presentation Type: VideoLoop