Abstract
A 35-year-old woman presented with a left groin swelling and pain over 6 months. Abdominopelvic computed tomography revealed no abnormalities. She elected to undergo a laparoscopic herniorrhaphy. Intraoperatively, a peritoneal sac could not be identified. We performed a totally extraperitoneal (TEP) repair considering the possibility of a sacless inguinal hernia. We additionally identified a femoral hernia containing retroperitoneal fatty tissue, which we repaired using a preperitoneal mesh using the TEP technique. The patient was discharged without complications on postoperative day 9. Surgeons should be aware of the occurrence of a sacless hernia and institute appropriate management to reduce the risk of recurrence after endoscopic hernioplasty.
