Incidental Femoral Hernias Diagnosed by Laparoscopic Approach: Does Gender Really Matter?

Aim: Laparoscopic approach in hernia repair enables to visualize all hernia orifices in the groin bilaterally and it may reveal a hernia in the groin region which had not been diagnosed with preoperative physical examination. Therefore, we aim to show incidence of incidental femoral hernias which are diagnosed during laparoscopic inguinal hernia repair. Methods: In this retrospective study 865 cases of inguinal hernia that und erwent laparoscopic approach for inguinal hernia repair at the Ibni Sina Hospital, Ankara between September 2014 and August 2019 were included. The patients’ demographic data, operative and postoperative course were studied. Results: Between September 2014 and August 2019 865 cases of inguinal hernia underwent laparoscopic hernia repair in our institute. 822 of patients were male and 43 were female. 841 cases underwent totally extraperitoneal (TEP) and 24 cases had trans -abdominal preperitoneal (TAPP) repair. 3 of the operations had started with TEP approach, due to peritoneal injury finished with TAPP. Inferior epigastric artery injury occurred 6 of TEP and 1 of TAPP patients, there were managed by laparoscopic sealing of the damaged vessels. 58 (41 TEP and 17 TAPP) of patients were diagnosed femoral hernia incidentally thanks to posterior approach of laparoscopic hernia repair within 865 patients (6,7%). 3 of these patients was female and 55 were male. During the operation femoral hernia repair was also performed to them. Conclusions: In conclusion femoral hernias, which had not been diagnosed preopera tively, can be incidentally diagnosed intraoperatively due to dissection of preperitoneal inguinal canal and hernias can be repaired at the same operation. Although ratio of femoral hernia for female patients is higher than the male patients in the literature, in this report ratio of femoral hernias diagnosed incidentally is similar between females and males.