Totally Extraperitoneal (TEP) Approach for Femoral Hernia

Purpose: The aims of this study were to evaluate the efficacy of laparoscopic totally extraperitoneal (TEP) repair of femoral hernia. Methods: Eight patients who underwent laparoscopic TEP repair for femoral hernia between 2008 and 2010 were reviewed retrospectively. In total, 256 adult patients underwent inguinal or femoral hernia repair; TEP was performed in 224 patients. The preoperative diagnosis, clinical symptom, operative finding, postoperative complications, chronic pain, and recurrence were analyzed. Results: The incidence of femoral hernia was 8 (3.1%) in the present study. The female to male ratio was 3 : 1 (6 females and 2 males). Seven patients were preoperatively misdiagnosed with inguinal hernia using ultra-sonography. Computed tomography (CT) was performed in three patients, and femoral hernia was diagnosed in two patients. Two patients had synchronous femoral hernia with direct or indirect inguinal hernia. One patient has previously undergone ipsilateral inguinal hernia repair. In all patients, the hernia sac was irreducible by gas insufflation. Seven patients had lipoma-like soft tissue in hernia sac. Peritoneal tears developed in three patients. There was one postoperative complication: chronic discomfort due to seroma. There was no recurrence during median 6.5 months (range 2 similar to 26). Conclusion: Laparoscopic TEP repair is safe and effective therapeutic option for repair of femoral hernia. CT images are the most valuable type for the evaluation of the femoral hernia. (J Korean Surg Soc 2010;79:393-398)