Appendix-preserving elective herniorrhaphy for de Garengeot hernia: two case reports.

Area of Science:

• Surgical Case Reports
• Hernia Surgery
• Gastrointestinal Surgery

Background:

• De Garengeot hernia involves the appendix within an inguinal hernia, often necessitating emergency appendectomy.
• However, elective management may allow for appendix preservation in select cases.

Purpose of the Study:

• To evaluate the feasibility of appendix-preserving elective herniorrhaphy for de Garengeot hernia.
• To determine criteria for successful non-operative management of the appendix in these cases.

Main Methods:

• Two elderly female patients diagnosed with de Garengeot hernia via computed tomography (CT).
• Appendix assessment using B-mode and color Doppler ultrasonography (US) to evaluate wall structure and blood flow.
• Herniorrhaphy with transabdominal preperitoneal (TAPP) repair performed without appendectomy after a period of observation.

Main Results:

• Ultrasonography revealed a normal appendix diameter (4-6 mm) with clear wall structure and pulsatile blood flow in both patients.
• Elective herniorrhaphy with TAPP was successfully performed without appendectomy in both cases.
• The appendix was preserved in both instances, with no reported complications related to the appendix.

Conclusions:

• De Garengeot hernia management can be tailored to preserve the appendix in elective settings.
• Appendiceal health, assessed by US and intraoperative findings, is crucial for deciding against appendectomy.
• Appendix-preserving herniorrhaphy is a viable option when appendicitis or circulatory compromise is absent.