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

2. INTRODUCTION AND OBJECTIVES

3. 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)

4. 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)

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

6. Methods

7. 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.

8. Methods : (2)

9. Methods : (3) Figure 2.Under laparoscopic herniorrhaphy

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

11. Methods : (5) Brief Video

12. Results

13. 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.

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

15. Conclusions

16. 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.