Abstract
A 77-year-old woman was admitted to hospital for a bulge and pain in the right inguinal area. Computed tomography (CT) showed that a tumor passed through the right femoral ring, and a cord-like structure connected the tumor and the cecum. A diagnosis of femoral hernia with incarceration of the appendix was made, and surgery was performed. On laparoscopy, the appendix was found to be incarcerated at the right femoral ring. The ring was approached through the extraperitoneal preperitoneal space, and the hernia sac was exfoliated. The sac was then ruptured, and the appendix was exposed to the space. The femoral ring was closed with sutures without mesh placement due to concern about infection. After suturing, laparoscopic appendectomy was performed.
Four months later, a second-stage laparoscopic repair of the femoral hernia was performed. The femoral hernia was repaired with mesh in the preperitoneal space by a totally extraperitoneal preperitoneal repair method. The patient's postoperative course was good. To date, there has been no hernia recurrence.
