A Review of 11 Cases of Obturator Hernia Repaired with Synthetic Mesh Using an Extra-Preperitoneal Approach

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 44; no. 7; pp. 921 - 927
• Main Authors: Yoshizawa, Junichi, Nakamura, Manabu, Ishizaka, Katsuhiko, Shibata, Hitoshi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2011
• Subjects: extraperitoneal approach; mesh; obturator hernia
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.44.921

We assessed 11 cases of mesh repair for obturator hernia using a midline extra-peritoneal approach. The Howship-Romberg sign and intestinal obstruction symptoms were recognized in 7 cases in each. The period from onset to operation was 12 hours to 7 days. To cover the obturator foramen, we used mesh sheets in 10 cases and a Kugel patch in 1 case. We repaired both sides of the obturator foramen in all cases. There were 7 cases of incarcerated small intestine, and 5 cases of resection of the intestine. We were able to prevent synthetic mesh infection by adequate washing and drainage of the preperitoneal cavity. The complications were 1 case of ileus, aspiration pneumonia and wound disruption, respectively, with no recurrences. The midline extra-peritoneal approach is useful to observe the bilateral obturator foramen and the operative field, with a minimum incision of the peritoneum at laparotomy, and peeling away a layer to lay down mesh to cover the obturator canal.