腹腔鏡下TEPヘルニア修復術と腸切除術：緊急嵌頓鼠径ヘルニアに対する汚染リスクを最小限に抑える安全なワンステージアプローチ

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.