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Pouch of Douglas pelvic hernia: a rare entity managed laparoscopically
J Bunni1, D Teichmann, J R Berstock
1Department of Upper GI Surgery, Weston General Hospital, Weston-super-Mare, UK. johnbunni@hotmail.com
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|February 4, 2011
Summary
Pouch of Douglas hernias are rare pelvic hernias. This case report details the successful laparoscopic repair of an idiopathic Pouch of Douglas hernia in an elderly woman, resolving her groin pain.
Area of Science:
- General Surgery
- Pelvic Anatomy
- Minimally Invasive Surgery
Background:
- Pouch of Douglas hernias are uncommon pelvic floor defects.
- Typically observed in multiparous, elderly women or post-pelvic surgery patients.
- Idiopathic presentation without prior surgical history is rare.
Observation:
- A 77-year-old female presented with groin pain attributed to a Pouch of Douglas hernia.
- The patient had no history of abdominal or pelvic surgery.
- Diagnosis was confirmed, and surgical intervention was planned.
Findings:
- The Pouch of Douglas hernia was successfully repaired using a trans-abdominal pre-peritoneal (TAPP) approach.
- The laparoscopic procedure resulted in complete resolution of the patient's groin pain.
- This represents the first reported case of an idiopathic Pouch of Douglas hernia managed laparoscopically.
Implications:
- Laparoscopic TAPP repair is a viable and effective treatment for Pouch of Douglas hernias.
- Highlights the possibility of idiopathic presentations, even without typical risk factors.
- Contributes to the literature on minimally invasive management of rare pelvic hernias.
