Transabdominal Preperitoneal Approach for Reduction en Masse of an Inguinal Hernia That Was Diagnosed Preoperatively

Abstract

A 77-year-old man with a history of repeated self-reduction of an inguinal hernia was transported urgently to our hospital complaining of frequent vomiting and worsening abdominal pain after the last self-reduction. Examination revealed that the hernia sac was lying in the preperitoneal space and that the herniated small intestinal segment was strangulated at the left internal inguinal ring. The inguinal hernia was repaired by surgery involving placement of a mesh in the preperitoneal space. Resection of the strangulated segment of the intestine with impaired blood flow was not needed as it showed no evidence of necrosis. Herein, we report 17 cases of reduction en masse, including our own case, documented in Japan.