Robotic-Assisted Laparoscopic Reduction and Repair of a Giant Incarcerated Recurrent Inguinal Hernia Containing Bladder and Both Ureters

Justin Harmon, DO, Lawrence Cetrulo, MD, Damon Hoffman, DO, Kelly Kriebel, RN, BSN, Amit R Joshi, MD

Albert Einstein Healthcare Network

Introduction. The DaVinci Robot is particularly useful in pelvic procedures, such as prostatectomy and low anterior resection. We describe the first case-report of a robotic-assisted repair of a giant bladder- and ureter-containing incarcerated inguinal hernia.

Case Report. A 53-year old man had previously undergone repair of a left inguinal hernia repair eight years ago at another institution. He presented to our clinic complaining of difficulty urinating and a large bulge in his left scrotum. Computed tomography revealed a giant left scrotal hernia containing 80% of the bladder, along with bilateral ureters. The patient underwent robotic-assisted laparoscopic repair of this defect. The bladder and both ureters were carefully dissected free from the scrotum, while preserving the testicle and spermatic cord. Intraoperative fluoroscopy and cystoscopy confirmed that there was no injury to the bladder or ureters. A 6×4 inch intra-peritoneal polyester composite mesh was then used to repair the defect.

Discussion. Incarcerated, recurrent inguinal hernias are challenging repairs. Robotic-assisted repair allows for a fine dissection, particularly because of its pelvic dissection. Robotic-assisted laparoscopy is an excellent alternative to open surgery for a difficult inguinal hernia.

Session: Poster Presentation

Program Number: P307

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