Laparoscopic total extraperitoneal repair of a recurrent inguinal hernia with incarcerated urinary bladder Oral Presenter: Huey-Sheng Jeng M.D. Taipei City Hospital Taiwan

INTRODUCTION AND OBJECTIVES

About 1%-4% of all inguinal hernias involve the urinary bladder. The diagnosis of urinary bladder involvement is often difficult to define at the time of presentation and may only become apparent at the time of herniorrhaphy. INTRODUCTION AND OBJECTIVES : (1)

Surgical management pertaining to the approach, laparoscopic herniorrhaphy may challenge the urologist. We report total extraperitoneal (TEP)laparoscopic herniorrhaphy of a recurrent inguinal hernia with incarcerated urinary bladder. INTRODUCTION AND OBJECTIVES : (2)

Our objectives to highlight the clinical presentation and the decisive issues surrounding the diagnosis and laparoscopic management of this condition. INTRODUCTION AND OBJECTIVES : (3)

Methods

METHODS : (1) A 72 year-old man had frequency,urgency, and left recurrent inguinal hernia with an incarcerated urinary bladder who was incidentally found out after physical examination and computed tomography scan and then underwent laparoscopic total extraperitoneal herniorrhaphy.

Methods : (2)

Methods : (3) Figure 2.Under laparoscopic herniorrhaphy

Methods : (4) Figure 3. Laparoscopic Herniorrhaphy with mesh

Methods : (5) Brief Video

Results

Results : (1) After laparoscopic herniorrhaphy, the herniated bladder was free from the structures within the inguinal canal and returned to its normal pelvic position. The lower urinary symptoms of the patient got improved.

Results : (2) Figure 4.Post-operative cystography

Conclusions

Conclusions : Diagnosis of such cases often required not only clinical examination but also specialized radiological investigations to show the incarcerated urinary bladder, laparoscopic herniorrhaphy in these patients is real challenge for urologist.