Femoral Hernia: Open and Laparoscopic Surgery Approaches

Femoral hernia comes out of abdominal cavity through the femoral canal and descends vertically to saphenous opening, and once escapes this opening it expands considerably, sometimes rising above the inguinal ligament. Due to its tortuous course, the hernia is usually irreducible and liable to strangulate. There are different open surgery choices. In low (Lockwood) operation, the sac is dissected out below the inguinal ligament via a groin-crease incision. In high (McEvedy) operation, the hernia is accessed via a horizontal (or vertical) incision made in lower abdomen at the lateral edge of rectus muscle. In Lotheissen’s operation, the hernia is approached through the inguinal canal. The last one is my preferred approach, as it also helps in dealing if the contents are strangulated. The laparoscopic approaches include both transabdominal preperitoneal repair (TAPP) and total extraperitoneal repair (TEP). This chapter will give an account of the advantages and disadvantages of these different surgical techniques.

Laparoscopic transabdominal preperitoneal repair of concurrent spigelian and groin hernias: a rare case

Spigelian hernia is a rare type of abdominal wall hernia due to congenital defect in the transversus aponeurosis fascia. It has a prevalence of 2%. Traditionally, an anterior hernioplasty was used to repair these defects. Only a few cases have been reported in the literature. Here we discuss a case of a 66 year old female with chronic lower abdominal pain with swelling in left inguinal area diagnosed with spigelian hernia on ct scan along with left direct hernia as well as left femoral hernia found incidentally and repaired using totally extra peritoneal single mesh repair.