[Loss of domain-a surgeon's challenge. Surgical approach to an enormous scrotal hernia]

We report on the one-stage procedure surgical approach to an enormous scrotal hernia bearing the whole small bowel and part of the large bowel as a loss of domain situation. Using a mesh-based component separation abdominal wall technique according to Ramirez we managed to retrieve the hernia content into the abdominal cavity allowing reduction of the resulting intra-abdominal pressure. We present our surgical approach in detail and report on the postoperative process based on focused intensive care surveillance and specific surgical complication management leading to hospital discharge of the patient on postoperative day 57.