Laparoscopic Repair of a Femoral Hernia Involving the Appendix in a Patient With a History of Extracorporeal Membrane Oxygenation After Myocardial Infarction

We present the case of a patient who underwent laparoscopic appendectomy and transabdominal preperitoneal repair for a femoral hernia involving the appendix after myocardial infarction and required veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We admitted a 61-year-old man who was experiencing swelling and pain in his right groin. His medical history included a myocardial infarction three years prior, for which he required VA-ECMO using the cutdown technique in our hospital. Abdominal computed tomography revealed a right femoral hernia involving the appendix, and the patient underwent laparoscopic surgery. During laparoscopy, the appendix, which had disengaged from the right femoral hernia, was facilitated by visualization. The appendix exhibited mild inflammation, and no abscess was found in the lumen of the right femoral hernia; therefore, the patient underwent laparoscopic appendectomy and transabdominal preperitoneal repair. In this patient with a femoral hernia involving the appendix, laparoscopic surgery was useful in the identification of the appendix, although the incarcerated appendix had disengaged from the femoral hernia at the time of surgery. Because it is unclear whether VA-ECMO using the cutdown technique is associated with femoral hernias, further case reports similar to ours would be valuable.