Laparoscopic treatment of incarcerated femoral hernia by TAPP

Laparoscopic treatment of incarcerated femoral hernia is not a routine procedure. After reviewing the three cases we tried to point out some surgical problems and assess safety and value of that kind of the procedure. By preoperative selection, we excluded the patients for whom we suspected might have a bowel so harmed that a resection would be necessary. By a native abdominal X-rays we estimated the bowel distenssion and the possibility of injury while establishing tile pneumoperitoneum. The basical technical problem is desincarceration. Cutting the lacunar ligament is a safe method, also used as the procedure at open operation. By using this method we ensure enough space that allows us to pull gentle incarcerated tissue back to abdomen. Our conclusion is that the laparoscopic treatment of incarcerated femoral hernia is a safe procedure when applied on selected patients, and by experienced laparoscopic surgeon. Undoubtedly, the method of choice is TAPP, because that procedure makes feasible the estimation of vitality of icarcerated structures.