Novel laparoscopic methods for inguinal hernia post pelvic fracture: A case report

Area of Science:

• Laparoscopic surgery
• Hernia repair
• Pelvic fracture management

Background:

• Elderly patients with pelvic fractures are susceptible to inguinal hernias.
• Post-pelvic fracture surgery, extensive preperitoneal adhesions can complicate inguinal hernia repair.
• This case highlights the challenges of managing inguinal hernias after pelvic fracture surgery.

Observation:

• An elderly male with a history of pelvic fracture surgery developed a right inguinal hernia.
• Laparoscopic evaluation revealed an indirect inguinal hernia with a widely open internal inguinal ring.
• Initial attempts at transabdominal preperitoneal approach (TAPP) were hindered by severe adhesions.

Findings:

• A modified intraperitoneal onlay mesh (mIPOM) approach combined with iliopubic tract repair (IPTR) was successfully employed.
• The patient experienced no recurrence or neurological pain six months post-operation.
• The laparoscopic approach allowed for flexibility in surgical strategy, including hybrid conversion.

Implications:

• Laparoscopic techniques offer versatile options for complex inguinal hernia repairs in challenging surgical fields.
• The mIPOM and IPTR combination provides a viable solution for inguinal hernias post-pelvic fracture surgery.
• This approach may reduce recurrence rates and improve patient outcomes in complex cases.