Laparoscopic TAPP for strangulated right obturator hernia

This video shows the case of a 92 years-old woman without previous abdominal surgery who came to the emergency room with signs of intestinal occlusion. CT scan revealed a strangulated right obturator hernia without signs of bowel necrosis. It`s an entity that represents 0.073% of all hernias and is difficult to diagnose, being usually diagnosed by CT scan. The surgical procedure was performed laparoscopically with exploration and reduction of the strangulated bowel. During reduction necrosis was observed and an extracorporeal resection and anastomosis was performed by a lateral assisted incision. Pneumoperitoneum was restored and the video shows the main steps necessary to be performed (sac reduction, prosthesis placement, peritoneal closure). The possibility to evaluate small bowel, explore and allow the management of all types of inguino-femoral hernias and faster recovery are considered advantages of the transabdomino-preperitoneal (TAPP) approach.^1–4