V-052 Laparoscopic Treatmenf of Spiegel Strangulated Hernia by TAPP Approach

Abstract Repair of hernia is a very common procedure performed by general surgeon. Laparoscopic approach has demonstrated advantages over direct approach: less complications, faster recovery and postoperative pain. In Spiegel hernias, if the ring than 2 cm, simple laparoscopic suture can be performed; however, transabdominal preperitoneal (TAPP) hernioplasty lower risk recurrence. We report case woman with strangulated which was attempted TAPP hernioplastly. 63 year old consulted in emergency for swelling left flank an occlusive syndrome. Physical examination found distended abdomen presence painful mass flank, irreducible. Radiological findings were inconclusive, so ultrasound showed abdominal wall defect 15×15 mm ischemic small bowel loop herniation: hernia. A exploratory laparoscopy emergently. It cm hole at 15 bowel. Ischemia confirmed indocyanine green (ICG). Afterwards, herniopplasty performed: peritoneal incision to create flap. The sac reduced then, we closed defect. After this, placed prosthesis covering area weakness pre-peritoneal space fixed biological glue. At least, covered mesh closure. Finally, resection isoperistaltic mechanical laterolateral extracorporeally anastomosis. She had unremarkable post-operative course, she discharge on 4th day.