A Case of Amyand's Hernia Treated by Appendectomy and Transabdominal Pre-peritoneal Repair as a Single Operation

Abstract

A 51-year-old man presented to a local clinic in October 2020 complaining of a right inguinal bulge and pain, and he was referred to our hospital with a suspected right inguinal hernia. Computed tomography in our hospital showed a right external inguinal hernia, with the appendix protruding into the hernial sac, and Amyand's hernia was diagnosed. Laparoscopic appendectomy and transabdominal pre-peritoneal repair (TAPP) were performed under general anesthesia with the patient in the supine position as a single operation. Six months postoperatively, no complications or recurrence of the hernia has been observed.

In Japan, Amyand's hernia is repaired by open inguinal surgery in over 90% of cases, but, recently, cases have been reported that started with a laparoscopic approach for intraperitoneal observation and to determine how to treat the appendix and hernia. To the best of our knowledge, excluding the present patient, only one other case in Japan and one case outside of Japan of simultaneous laparoscopic appendectomy and hernia repair by TAPP have been reported previously. In the present case, laparoscopic appendectomy and TAPP were performed as a single operation to treat Amyand's hernia, with good results, and this rare case is reported along with a short discussion of the literature.