A Case of Incarcerated Incisional Hernia Treated by Laparoscopic Surgery

Abstract

A 52-year-old man was admitted to our hospital 18 hours after the sudden onset abdominal pain and vomiting. Abdominal distention and pain at the site of his scar of past operation for appendicitis was observed. Abdominal computed tomography revealed dilated small intestine and incarcerated incisional hernia. Laparoscopic surgery was performed under the diagnosis of an incarcerated incisional hernia with ileus. After the incarcerated small intestine was released by opening the hernia orifice with an ultrasonically activated scalpel, the small intestine was viable and needed no resection. The hernia orifice was repaired with intraperitoneal on-lay mesh with a double crown tacking technique. The postoperative period was uneventful and the patient was discharged without any complications on the 6th postoperative day. No recurrence has been observed during follow-up. Laparoscopic surgery is useful for incarcerated incisional hernia because it simultaneously enables accurate diagnosis, evaluation of the viability of the incarcerated organ and repair of the hernia orifice.