Abstract
Obturator hernia commonly affects elderly age people and general conditions of the patients have often deteriorated when they are diagnosed. Conventionally surgery for the hernia was performed via an abdominal approach (laparotomy), but recently an inguinal approach has been increasingly performed as a less invasive procedure. In our hospital, we have experienced consecutive seven cases of obturator hernia operated on via the inguinal approach. We used epidural anesthesia, local anesthesia, and added mild sedation using propofol and nitrous oxide. Surgery was performed via the inguinal approach to enter the preperitoneal cavity, and reduced the hernia. After the hernia sac was treated, the preperitoneal cavity was sufficiently washed and then the hernia opening was widely covered with polypropylene mesh. In one case in which bowel necrosis was noted, bowel resection and anastomosis were done. The patients had uneventful postoperative course without particular complications. The median interval from operation to first walking was two days, the median interval from operation to flatus was one day, and the median postoperative hospital stay was 10 days.
Accordingly the inguinal approach is less invasive, carries early recovery, and can be safely done even for patients in a poor general condition. The inguinal approach is considered to be a standard operative procedure for obturator hernia as a less invasive surgical procedure.
