چکیده (انگلیسی):

Introduction: Using laparoscopic methods for incarcerated scrotal hernias is
controversial because of the perceived technical difficulties in treating such hernias. Herein,
we present our experience with laparoscopic repair of such hernias.
Materials and methods: A retrospective review was undertaken to evaluate our experience with
laparoscopic transabdominal approach and its modification for incarcerated hernias over a 3-
year period. Two laparoscopic techniques were used for the repair of such hernias. The first
technique, an exploratory laparoscopy, was performed to inspect the content of the hernia.
This was followed by gentle retraction of the hernial content into the abdominal cavity and performing
a standard transabdominal preperitoneal (TAPP) repair. If the hernia was not reducible,
then a second technique involving a paramedian scrotal incision was performed. The sac was
isolated, opened, and its contents were examined. If the bowel was encountered, it was
reduced into the peritoneal cavity. However, if it was the omentum, it was excised. Following
ligation of the scrotal sac and re-insufflation of the abdomen, a standard TAPP ensued.
Results: A total of 20 male patients with incarcerated scrotal hernia underwent laparoscopic
TAPP repair (mean age: 48 years). Six had scrotal incision. Surgical site or mesh infection was
not observed in any of the cases. Likewise, no recurrence after a mean follow-up of 22 months
was encountered.
Conclusion: Using the above modifications, we were able to perform laparoscopic repair of large
incarcerated scrotal hernias, which previously would have been treated with an open procedure.