Laparohernioscopic right colectomy for bowel ischaemia within a strangulated inguinal hernia

Abstract

Visual inspection of the content of the hernia sac is a crucial step of the emergency repair of strangulated inguinal hernias, to rule out the presence of bowel ischaemia which would need resection. Occasionally the content of the hernia sac reduces spontaneously into the abdomen after the induction of general anaesthesia and cannot be assessed. We present a case where hernioscopy t(i.e. laparoscopy through the hernia sac) has been used to confirm the ischaemia of the strangulated bowel and perform a hybrid laparohernioscopic right colectomy with intracorporeal anastomosis without the need for a formal laparotomy. Hernioscopy is an easy and reliable method to assess the viability of the content of the hernia sac in strangulated hernias that have spontaneously reduced before it could be visually inspected. It can also be associated with a laparoscopic access in a hybrid laparohernioscopic technique to perform complex procedures.