Laparoscopic Inguinal Hernioplasty for Bilateral Giant Inguinal Hernia by Monitoring the Intra-bladder Pressure—Report of a Case—

Abstract

A 66-year-old man had noticed left-sided inguinal swelling for 10 years. In recent 5 years, the right-sided groin also became bulged ; then, the swelling of both sides gradually increased. Each scrotum sized 20×10×10cm reaching the middle of the thigh, then the patient was diagnosed with bilateral giant inguinal hernia. To avoid acute abdominal compartment syndrome, we measured the perioperative intra-bladder pressure which is considered to refer the intra-abdominal pressure. After induction of general anesthesia, we returned bilateral hernia contents, when we could observe the intra-bladder pressure remained in normal range. Therefore, we decided to perform bilateral hernia repair at one time by the trans-abdominal preperitoneal approach. When the patient came out from the anesthetic after the surgery, the intra-bladder pressure only mildly elevated. We did not observe postoperative abdominal compartment syndrome. He was discharged on the 7^th postoperative day. No recurrence is seen 6 months after the operation. In conclusion, by monitoring perioperative intra-bladder pressure, we could safely repair the bilateral giant hernia at one time.