If laparoscopic technique can be used for treatment of acutely incarcerated/strangulated inguinal hernia?

Laparoscopic treatment for acutely incarcerated/strangulated inguinal hernias is uncommon and controversial. In the present study, we assessed the safety and feasibility of transabdominal preperitoneal (TAPP) repair for the treatment of acutely incarcerated/strangulated inguinal hernias.

Patients with acutely incarcerated/strangulated inguinal hernias who underwent TAPP repair at the Department of Hernia and Abdominal Wall Surgery (Beijing Chaoyang Hospital) from January 2017 to December 2019 were retrospectively reviewed. Patients' characteristics, operation details, and postoperative complications were retrospectively analyzed.

In total, 94 patients with acutely incarcerated/strangulated inguinal hernias underwent TAPP repair. The patients comprised 85 men and 9 women (mean age, 54.3 ± 13.6 years; mean operating time, 61.6 ± 17.7 min; mean hospital stay, 3.9 ± 2.2 days). No patients were converted to open surgery. Hernia reduction was successfully performed in all patients. The morbidity of complications was 20.2% (19/94). Two bowel resections were performed endoscopically. Nine (9.6%) patients avoided unnecessary bowel resections during laparoscopic procedures. All patients recovered well without severe complications. No recurrence or infection was recorded during a mean follow-up period of 26.8 ± 9.8 months.

TAPP appears to be safe and feasible for treatment of patients with acutely incarcerated/strangulated inguinal hernias. However, it requires performed by experienced surgeons in laparoscopic techniques.