Abstract
An 83-year-old man was evaluated for right inguinal bulging that he had first noticed during childhood. Examination showed a bulge the size of a small child's head extending from the right inguinal region to the thigh. A left inguinal bulge the size of a fist was also noted. Abdominal computed tomography showed ileal, right colon, and omental protrusion into the right inguinal hernia ; and bladder protrusion into the left inguinal hernia. Nonreducible giant inguinal hernias were diagnosed, and single-incision laparoscopic totally extraperitoneal repair (SIL-TEP) was used to repair bilateral hernias.
Early postoperative seroma was noted, but improved with conservative management. The patient has shown a good postoperative course over 9 months without hernia recurrence. SIL-TEP : 1) is aesthetically superior ; 2) permits safe reduction of hernial contents and treatment of the hernial sac ; and 3) enables wide extraperitoneal dissection for sufficiently large mesh placement. We believe that SIL-TEP may become the surgical procedure of choice for nonreducible giant inguinal hernia.
