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Case Report

Impacted obturator hernia treated successfully with a Kugel repair: Report of two cases

Shinji MuraiContact Information, 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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