Non-operative management of obturator hernia in an elderly female

Obturator hernia is a rare surgical condition, with about 800 cases being reported in the literature. It can cause significant morbidity and mortality, especially in the elderly age group. Delayed treatment is associated with high rates of strangulation (25–100 %). The mainstay of management for obturator hernia has been surgical. Non-operative management can lead to significant morbidity and mortality, but may be an option in patients who decline surgery, as described in our case.     

Laparoscopic obturator hernia repair in an adolescent

Obturator hernia is rare and has not been described in the pediatric population. The authors describe a case in a 12-year-old girl who presented with nonspecific abdominal pain and who was treated with a laparoscopic primary hernia repair.     

浅谈如何做好腹股沟疝修补术

腹股沟疝修补术(HR)是最常见的手术,在美国每年超过50万例,我国更多.自1884年Bassini首倡HR以来,具有代表性的改革术有Halsted(1889)、Ferguson(1893)、McVay(1942)、Shouldice(1945)、Lichtenstein(1981)以及新近开展的腹腔镜网片修补术(LHR)等.复发率是评价HR疗效的唯一标准.HR应该是修复腹股沟管后壁处的缺损,Ferguson术达不到这一要求,故现已被弃用.     

Endoscopic patch repair of inguinal hernia in a female patient

Summary This is a photographically well documented case report of endoscopic patch repair of an inguinal hernia in a female patient. The surgical steps as well as the repair materials are described in detail. Patch repair of abdominal hernias is a promising new application of minimally invasive endoscopic surgery.     

Technique for inguinal hernia repair in the elderly patient

A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in very old patients, with almost completely atrophied muscles.     

Effectiveness of diaphragmatic repair using an abdominal muscle flap in patients with recurrent congenital diaphragmatic hernia

Background/Purpose

Recurrent congenital diaphragmatic hernia (Re-CDH) is a well-known complication of CDH repair. Although surgical treatment is required for Re-CDH, the question regarding which technique is the optimal treatment has not yet been elucidated. We performed a repair using an abdominal muscle flap (AMF) for Re-CDH and herein report our experience.

Patients and Results

Four patients using AMF had left Re-CDH. The patient's age at operation was around 1 year old in all patients. In the first repair during the neonatal period, a Gore-Tex patch was required for the large defect in 3 patients, whereas a primary closure was selected in 1 patient because the anterior diaphragm remained as a partial remnant. In the 3 patients in whom a Gore-Tex patch was used in the first operation, recurrence occurred twice. All of the patients suffered from both pulmonary hypertension and growth retardation. A repair using AMF (the flap of both the internal oblique and the transversalis abdominal muscle) was performed in all patients. The clinical course was good in all patients, with an improvement of both pulmonary hypertension and growth retardation without any recurrence of CDH.

Conclusion

The use of an AMF was thus found to be an effective technique for repairing a large defect in Re-CDH.     

Mesh migration following obturator hernia repair presenting as a bezoar inducing small intestinal obstruction

This is the first report on synthetic mesh migration following obturator hernia repair. Obturator hernias have a low incidence – with fewer than 700 published case studies to date – usually occur in elderly women and are difficult to diagnose. Since 1976, there have been no more than 29 reported cases in which synthetic materials were used in obturator hernia repair. Thus, information relevant to the surgical repair of this type of hernia is based on small numbers only. The use of synthetic mesh for the repair of obturator hernias is a recent development, and to date no complications have been reported with this type of repair. We report here on the outcome of a patient with mesh migration after obturator hernia repair. This report provides a short overview of mesh migration as a complication following the use of synthetic grafts for surgical repair.     

Laparoscopic dual mesh repair of a diaphragmatic hernia of Bochdalek in a symptomatic elderly patient

Bochdalek hernia is a congenital posterolateral diaphragmatic defect. It is usually diagnosed in newborns and children; the mortality rate is high due to further congenital anomalies such as pulmonary hypoplasia and pulmonary hypertension. In adulthood, the diagnosis is often incidental, while sometimes it is related to gastrointestinal or respiratory symptoms, or to herniated viscera complications. Thus, surgical treatment is advocated. We herein report a case of an 86-year-old woman with dyspnea and dysphagia. After the diagnosis by barium enema and CT scan of the herniated stomach and the greater omentum through a left side foramen of Bochdalek, she underwent a successful laparoscopic dual mesh repair and was discharged on the 6th postoperative day.