Transabdominal Preperitoneal Repair With Concomitant Bowel Resection for Strangulated Femoral Hernias: A Report of Five Cases

It is controversial whether prosthetic mesh can be used laparoscopically in emergency groin hernia repair when bowel resection is needed. While the guideline for emergency hernia repair recommends the use of prosthetic mesh in a clean-contaminated wound based on the studies with the open anterior approach, evidence supporting the laparoscopic use of prosthetic mesh in a clean-contaminated wound is scarce. The present paper reports the procedure and the clinical outcome of five patients treated by transabdominal preperitoneal (TAPP) repair with concomitant bowel resection for strangulated femoral hernia between 2015 and 2024 at Kobayashi Hospital, Kitami, Japan. The hernia was laparoscopically reduced by enlargement of the hernia orifice with traction and compression on the intestine, followed by TAPP repair and extracorporeal small intestinal resection at the same surgery. There was no conversion to open surgery or infectious complications. The results of our report and earlier literature support that TAPP repair with concomitant bowel resection for strangulated groin hernia appears to be feasible and safe, although further studies are needed to verify the safety of this procedure.