Hernioscopy: a reliable method to explore the abdominal cavity in incarcerated or strangulated inguinal hernias spontaneously reduced after general anaesthesia
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The diagnosis of bowel or omental ischaemia in strangulated inguinal hernias needs visual exploration of the content of the hernia sac. In some cases, the content of the sac retracts spontaneously into the abdomen at the induction of anaesthesia, so making sure of its viability can be quite difficult. Hernioscopy can allow direct inspection of the whole abdominal cavity and the performance of surgical procedures such as small bowel, large bowel or omental resection, without the need of a formal laparotomy.
Hernioscopy entails inserting a 10–12-mm trocars in the hernia sac, after its complete mobilization. A 30° camera is then passed into the abdomen through the sac and a thorough examination of the abdominal cavity is performed. If necessary, accessory trocars can be inserted into the hernia sac or through the abdominal wall to perform additional procedures such as bowel resection. After the exploration and the eventual resection, the operation is concluded with a tension-free mesh repair of the hernia.
We performed hernioscopy on eight patients. In four of them, no ischaemia was found and the operation was concluded with mesh repair of the hernia. In four patients, a further operative procedure was necessary. No significant postoperative surgical complications were recorded.
Hernioscopy is an easy and reliable method to explore the abdominal cavity and make sure of the viability of the bowel in patients with strangulated inguinal hernia and to proceed to minimally invasive resection if needed.
KeywordsStrangulated inguinal hernia Hernioscopy Bowel ischaemia Emergency bowel resection
Compliance with ethical standards
Conflict of interest
Giovanni D. Tebala, Aderemi Kola-Adejumo and Janelle Yee have no conflicts of interest or financial ties to disclose.
Formal approval by the Ethical Committee was not deemed to be necessary due to the retrospective nature of the study.
Statement on human and animal rights
This article does not contain any study with animals performed by any of the authors.
Formal written consent to participate in the study was not obtained from participants because the study reports the results of a retrospective analysis of fully anonymised clinical data. All patients were fully informed before the operation and gave written consent.