Introduction:
An indirect inguinal hernia is an inguinal hernia that results from the failure of embryonic closure of the deep inguinal ring after the testicle has passed through it. Like other inguinal hernias, it protrudes through the superficial inguinal ring. It is the most common cause of groin hernia. Inguinal hernia repair, also known as herniorrhaphy, is the surgical correction of an inguinal hernia. An inguinal hernia is an opening, weakness, or bulge in the lining tissue (peritoneum) of the abdominal wall in the groin area between the abdomen and the thigh. The surgery may be a standard open procedure through an incision large enough.
The management of strangulated hernias using the anterior inguinal approach has not been well addressed in the literature. The purpose of this study was to describe cases of strangulated inguinal hernia in our institution where resection anastomosis and hernia repair were done concomitantly thru the anterior inguinal approach. Of 369 hernia operations, 20 had strangulated bowel. One patient had diffuse peritonitis requiring immediate laparotomy. In the remaining 19 patients, the anterior inguinal approach was used. All patients were male, had indirect inguinal hernias, with a mean age of 38 years. Seventeen patients (89.5%) had resection-anastomosis and inguinal floor repair performed through the anterior inguinal approach. Two patients (10.5%) subsequently required an additional midline incision. Two patients developed superficial surgical site of infections (10.5% morbidity rate). A patient died due to a missed bowel injury (5.3% mortality rate). No breakdown of the inguinal floor repairs was noted. In our experience, the anterior inguinal approach for strangulated hernia is safe and effective for majority of patients, and that mortality and morbidity rates are within acceptable limits. However, difficulties with the incision, or doubts as to the actual extent of the intraabdominal pathology should still warrant...