One-Stage Totally Extraperitoneal Mesh Repair for Incarcerated Groin Hernias With Separated Operative Fields

Incarcerated groin hernia is a challenging emergency, and the optimal surgical approach-particularly regarding mesh use when bowel resection is required-remains controversial.

We retrospectively reviewed 13 patients who underwent emergency repair of incarcerated groin and obturator hernias using a standardized laparoscopy-assisted totally extraperitoneal (TEP) technique with separated operative fields. Diagnostic laparoscopy was used for inspection and reduction, followed by single-incision plus one-port TEP mesh repair, and re-laparoscopy for bowel assessment. When necessary, bowel resection was performed through an extended umbilical incision, maintaining field separation. Thirteen patients were treated with this approach, which allowed one-stage mesh repair even in cases requiring bowel resection.

This combined intraperitoneal and extraperitoneal approach enables safe one-stage mesh repair even when bowel resection is required by minimizing contamination risk through spatial separation. The technique may expand the applicability of TEP in emergency settings.