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Impacted obturator hernia treated successfully with a Kugel repair: Report of two cases
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Case Report
Impacted obturator hernia treated successfully with a Kugel repair: Report of two cases
Shinji Murai1 , Tomotaka Akatsu1, Nobushige Yabe1, Yoshitaka Inoue1, Yukako Akatsu2 and Yuko Kitagawa2
| (1) |
Department of Surgery, Ogikubo Hospital, 3-1-24 Imagawa, Suginami-ku, Tokyo 167-0035, Japan |
| (2) |
Department of Surgery, Keio University School of Medicine, Tokyo, Japan |
Received: 11 August 2008 Accepted: 10 November 2008 Published online: 24 September 2009
Abstract Obturator hernia repair has traditionally been performed via an intra-abdominal approach, although laparoscopy is also emerging
as a feasible alternative. On the other hand, the Kugel method is a minimally invasive and effective form of repair of groin
hernia, but there have been few reports on its use for an incarcerated obturator hernia. We describe how we used the Kugel
method to repair an obturator hernia in two patients. Both patients presented with acute intestinal obstruction, necessitating
emergency surgery. Via a preperitoneal approach, the impacted obturator hernia was carefully released and the obturator canal
defect was repaired with a Kugel patch. One patient recommenced oral intake on postoperative day (POD) 1, and was discharged
on POD 5. The other patient’s postoperative course was complicated by ileus, prolonging the hospital stay to 14 days. There
has been no sign of recurrent disease for 6 and 21 months, respectively. The Kugel method offers several advantages, such
as a short operative time (76–82 min), small scar (3 cm), and early postoperative ambulation (POD 1), thus minimizing the
hospital stay. Further study is needed to confirm the usefulness of this procedure for an incarcerated obturator hernia.
Key words Obturator hernia - Kugel repair - Intestinal obstruction
S. Murai and T. Akatsu contributed equally to this study.
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