Two Cases of Obturator Hernia Repaired by the Direct Kugel Method Using the Inguinal Approach

Abstract

Obturator hernia commonly affects elderly women who often have various comorbidities. Incarcerated obturator hernia can cause intestinal obstruction, manifesting with symptoms such as abdominal pain and vomiting. Obturator hernia is often treated by emergent laparotomy under general anesthesia. Nowadays, the usefulness of CT examination for early diagnosis, which enables non-invasive manual reduction, and the usefulness of elective surgery, are being reported. Less invasive surgery, such as via the inguinal approach and laparoscopic surgery, have been increasingly adopted. We encountered two cases of incarcerated obturator hernia, in whom surgery was performed by the direct Kugel method using the inguinal approach. One 91-year-old woman was operated electively after reduction of the incarcerated intestine using an ultrasonic probe. Another 92-year-old woman was operated emergently. Neither patient had any postoperative complications. Obturator hernia repair by the direct Kugel method appears to be very beneficial for patients, as it is less invasive and enables total hernia repair.