ELECTIVE LAPAROSCOPIC HERNIA REPAIR FOR AN OBTURATOR HERNIA DIAGNOSED BY BARIUM-ENEMA FLUOROSCOPY

Abstract

We have successfully performed an elective laparoscopic hernia repair for a patient with obturator hernia diagnosed when full symptoms did not still manifest. A 65-year-old woman was seen at the hospital because of a sensation of abdominal fullness after meals. Barium enema fluoroscopy revealed that a portion of the sigmoid colon wall protruded into the left obturator canal, which was a phenomenon consistent with Richter's hernia. It was considered that the patient had not manifested any symptoms of intestinal obsruction because the protruded portion was able to readily come back to the proper position. She was diagnosed as having an obturator hernia and underwent an elective laparoscopic hernia repair by a transabdominal preperitoneal approach.
The preoperative diagnosis of obturator hernia is seldom made unless patients should manifest some symptoms of intestinal obstruction. Further, the hernia is, at times, found bilaterally or in combination with different types of internal hernia. In such occasions, laparoscopic hernia repair that is minimally invasive and makes a through exploration of the peritoneal cavity possible at operation.