Preperitoneal Mesh Placement with Anterior Approach in Incarcerated Femoral Hernia (Our Experiences with 23 Cases)

Aim: To investigate the effectiveness of preperitoneal mesh\udplacement with anterior approach in incarcerated femoral hernia\udand to reveal morbidity and recurrence rates.\udMethods: Twenty-three patients with incarcerated inguinal\udhernia, who were admitted to our emergency surgery clinic\udbetween the years 2009 and 2012 and found to have incarcerated\udfemoral hernia during exploration, were included in the study.\udAll patients underwent inguinal transverse incision suitable for\udanterior approach. By cutting transversalis fascia, polypropylene\udmesh was placed preperitoneally between Cooper‘s ligament and\udthe conjoint tendon.\udResults: The mean age was 54.2 (39-85) years; 16 (69%) subjects\udwere men, 7 (31%) were women. Five patients had no complaints\udrelated to hernia before being admitted to the hospital. Six (26%)\udpatients underwent bowel resection and anastomosis. Small\udintestines or omentum incarcerated in the hernia sac were reduced\udinto the abdomen in 17 (74%) patients. There was no complication\udduring surgical interventions. Average length of hospital stay in\udpatients with resection and anastomosis were 5.3 days, and 2.1\uddays in patients with no resection. In follow-up, 3 (13%) patients\udhad hematoma-seroma and 2 (8%) patients had wound infection.\udIn 2-4 years follow-up, no recurrence was detected. Chronic pain\udrelated to nerve damage was not observed.\udConclusion: Preperitoneal mesh placement with anterior approach\udin incarcerated femoral hernia as an emergency is safe in terms\udof complications and recurrence either with or without intestinal\udresection. (The Medical Bulletin of Haseki 2015; 53: 196-8