Bilateral Giant Scrotal Hernia Treated with Intraabdominal Mesh Repair, Component Separation, and Reduction Scrotoplasty

 We report a 59 year-old male patient with bilateral giant inguino-scrotal hernia. The total volume of the scrotal hernias was almost 50% of the intraabdominal volume. Progressive pneumoperitoneum was tried to enhance intraabdominal volume before the repair, however the patient could not tolerate it. Therefore, he was scheduled for a single-stage transabdominal preperitoneal mesh repair and midline closure facilitated with component separation. Hernia sac content was small intestinal loops, sigmoid colon, and omentum. Standard polypropylene meshes were used for preperitoneal hernia repairs. Bilateral component separations were done and the midline was closed. A large sheet of partially absorbable lightweight composite mesh was laid on the abdominal wall to cover the midline and separation areas. Reduction scrotoplasty was employed by plastic surgeon as the latest stage of the surgery. The patient stayed in the ICU for 2 days but did not need mechanical ventilation, and was discharged on postoperative 19th day