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Lateral Supravesical Hernia Successfully Treated With the Totally Extraperitoneal (TEP) Approach With Adjunctive
Masato Hayashi1, Naoki Horikawa1
1Surgery, Takaoka City Hospital, Toyama, JPN.
This case report highlights lateral supravesical hernias, a rare condition often misdiagnosed. A totally extraperitoneal (TEP) repair proved safe and effective, avoiding bladder injury during surgery.
Area of Science:
- Abdominal Surgery
- Hernia Repair
- Minimally Invasive Surgery
Background:
- Lateral supravesical hernias are rare external hernias.
- They present with nonspecific symptoms, leading to misdiagnosis.
- Accurate preoperative diagnosis is challenging.
Observation:
- An 81-year-old male presented with right lower quadrant discomfort and an inguinal bulge.
- Preoperative CT showed a hernia sac of unclear origin.
- Laparoscopic observation identified the hernia orifice lateral to the bladder.
Findings:
- A transabdominal preperitoneal (TAPP) approach was converted to a totally extraperitoneal (TEP) repair.
- The hernia was successfully reduced from the preperitoneal space.
- Mesh placement was achieved without peritoneal violation.
Implications:
- Intra-abdominal observation aids in diagnosing atypical hernias.
- TEP repair is a safe and effective treatment for hernias near the bladder.
- This approach minimizes the risk of bladder injury during surgery.
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