J Minim Invasive Surg.  2020 Jun;23(2):93-98. 10.7602/jmis.2020.23.2.93.

Which Patients Are a Better Candidate of Laparoscopic Repair in Obturator Hernia Patients?

• Kwak JS
• Lee SE
• Park SM
• Lee SJ
• Kwon SU
• Bae IE
• Sung NS
• Moon JI
• Yoon DS
• Choi IS
• Choi WJ

• KMID: 2502949
• DOI: http://doi.org/10.7602/jmis.2020.23.2.93

Abstract

Purpose
Obturator hernia is a difficult disease to diagnose. If a surgical treatment is delayed in obturator hernia, a bowel resection may be required due to strangulation. The surgical treatment of this disease is to use a classical laparotomy. Recently, the laparoscopic approach has been reported and reviewed for efficiency. We checked the indicators that determine the most appropriate surgical method according to the patient’s condition.
Methods
In the study, a single-institution, retrospective analysis of surgical patients undergoing an obturator hernia surgery between 2003 and 2018 was performed. The patients were divided into a laparoscopic group (5 patients underwent laparoscopic repair; no intestinal resection) and an open group (13 patients who underwent open repair; 10 with and 3 without intestinal resection). The outcomes were compared between the groups. We analyzed the relevant factors that could predict the proper method of surgery.
Results
A total 18 patients were included in the study. All patients were female, with body mass index (BMI) of under 21 kg/m2. Of the various factors, only the WBC and CRP counts were the factors that had shown significant differences between the two groups. It is noted that patients with open surgery had a higher WBC counts (10406 versus 6520/μl; p=0.011) and CRP counts (7.84 vs. 0.32 mg/dl; p=0.027).
Conclusion
Obturator hernia can be treated with a laparoscopic surgery. The choice of surgical treatment can be considered in advance through the review of the patient’s WBC count or CRP count.

Keyword

Obturator hernia; Laparoscopy; Hernia repair; Laparotomies