Preperitoneal mesh placement with anterior approach in incarcerated femoral hernia (Our experiences with 23 cases)

Abstract

Aim: To investigate the effectiveness of preperitoneal mesh placement with anterior approach in incarcerated femoral hernia and to reveal morbidity and recurrence rates. Methods: Twenty-three patients with incarcerated inguinal hernia, who were admitted to our emergency surgery clinic between the years 2009 and 2012 and found to have incarcerated femoral hernia during exploration, were included in the study. All patients underwent inguinal transverse incision suitable for anterior approach. By cutting transversalis fascia, polypropylene mesh was placed preperitoneally between Cooper's ligament and the conjoint tendon. Results: The mean age was 54.2 (39-85) years; 16 (69%) subjects were men, 7 (31%) were women. Five patients had no complaints related to hernia before being admitted to the hospital. Six (26%) patients underwent bowel resection and anastomosis. Small intestines or omentum incarcerated in the hernia sac were reduced into the abdomen in 17 (74%) patients. There was no complication during surgical interventions. Average length of hospital stay in patients with resection and anastomosis were 5.3 days, and 2.1 days in patients with no resection. In follow-up, 3 (13%) patients had hematoma-seroma and 2 (8%) patients had wound infection. In 2-4 years follow-up, no recurrence was detected. Chronic pain related to nerve damage was not observed. Conclusion: Preperitoneal mesh placement with anterior approach in incarcerated femoral hernia as an emergency is safe in terms of complications and recurrence either with or without intestinal resection.