DIAGNOSTIC HERNIOSCOPY TO CHECK INTESTINAL RECOVERY IN URGENT SURGERY FOR INCARCERATED HERNIA
EAES Academy. Trujillo-Díaz J. 07/05/22; 363095; P140
Abstract
Aims:
Inguino-crural hernia surgery is a frequent pathology in emergency surgery. Incarcerated inguinal hernia sometimes requires intestinal resection. This situation sometimes depends on the surgeon's experience. The aim of this work was to propose the performance of a low pressure laparoscopy, through the hernial orifice, to visualize the released intestinal loop and its correct recovery after its reintroduction into the abdominal cavity.
Methods:
Most of our patients with incarcerated hernia have several pathologies, so urgent intervention is performed under spinal anesthesia. Since 2015, if during the intervention the intestinal loop was reintroduced without verifying its complete recovery or if there were doubts about it, a laparoscopy was performed through the hernial orifice, to verify the viability of the intestinal loop.
Results:
In the last 6 years, 8 patients undergoing emergency surgery under spinal anesthesia due to incarcerated inguinal or femoral hernia were collected. A "hernioscopy" was performed through the hernial orifice sac, in order to identify the intestinal loop once it had been reduced. A 10 mm optical trocar was inserted with the video endoscope and CO2 was injected at a low pressure of 4-6 mmHg. Complete recovery of the intestinal loop was verified in all cases. The trocar and gas were removed. The hernial sac was closed and the hernia was repaired using low-density mesh according to standard techniques.
CONCLUSION(S): In our series it was possible to see the bowel loops of the 8 patients, allowing their adequate treatment, without complications and with an early discharge from hospital. If it had not been visualized, the patient would have been admitted for observation for an additional 24 - 48 hours, or complementary studies such as analytics or imaging tests would have been performed. Hernioscopy is a resource available in any surgery service today, which can allow checking intestinal viability in a safe and non-aggressive way for patients.
Inguino-crural hernia surgery is a frequent pathology in emergency surgery. Incarcerated inguinal hernia sometimes requires intestinal resection. This situation sometimes depends on the surgeon's experience. The aim of this work was to propose the performance of a low pressure laparoscopy, through the hernial orifice, to visualize the released intestinal loop and its correct recovery after its reintroduction into the abdominal cavity.
Methods:
Most of our patients with incarcerated hernia have several pathologies, so urgent intervention is performed under spinal anesthesia. Since 2015, if during the intervention the intestinal loop was reintroduced without verifying its complete recovery or if there were doubts about it, a laparoscopy was performed through the hernial orifice, to verify the viability of the intestinal loop.
Results:
In the last 6 years, 8 patients undergoing emergency surgery under spinal anesthesia due to incarcerated inguinal or femoral hernia were collected. A "hernioscopy" was performed through the hernial orifice sac, in order to identify the intestinal loop once it had been reduced. A 10 mm optical trocar was inserted with the video endoscope and CO2 was injected at a low pressure of 4-6 mmHg. Complete recovery of the intestinal loop was verified in all cases. The trocar and gas were removed. The hernial sac was closed and the hernia was repaired using low-density mesh according to standard techniques.
CONCLUSION(S): In our series it was possible to see the bowel loops of the 8 patients, allowing their adequate treatment, without complications and with an early discharge from hospital. If it had not been visualized, the patient would have been admitted for observation for an additional 24 - 48 hours, or complementary studies such as analytics or imaging tests would have been performed. Hernioscopy is a resource available in any surgery service today, which can allow checking intestinal viability in a safe and non-aggressive way for patients.
Aims:
Inguino-crural hernia surgery is a frequent pathology in emergency surgery. Incarcerated inguinal hernia sometimes requires intestinal resection. This situation sometimes depends on the surgeon's experience. The aim of this work was to propose the performance of a low pressure laparoscopy, through the hernial orifice, to visualize the released intestinal loop and its correct recovery after its reintroduction into the abdominal cavity.
Methods:
Most of our patients with incarcerated hernia have several pathologies, so urgent intervention is performed under spinal anesthesia. Since 2015, if during the intervention the intestinal loop was reintroduced without verifying its complete recovery or if there were doubts about it, a laparoscopy was performed through the hernial orifice, to verify the viability of the intestinal loop.
Results:
In the last 6 years, 8 patients undergoing emergency surgery under spinal anesthesia due to incarcerated inguinal or femoral hernia were collected. A "hernioscopy" was performed through the hernial orifice sac, in order to identify the intestinal loop once it had been reduced. A 10 mm optical trocar was inserted with the video endoscope and CO2 was injected at a low pressure of 4-6 mmHg. Complete recovery of the intestinal loop was verified in all cases. The trocar and gas were removed. The hernial sac was closed and the hernia was repaired using low-density mesh according to standard techniques.
CONCLUSION(S): In our series it was possible to see the bowel loops of the 8 patients, allowing their adequate treatment, without complications and with an early discharge from hospital. If it had not been visualized, the patient would have been admitted for observation for an additional 24 - 48 hours, or complementary studies such as analytics or imaging tests would have been performed. Hernioscopy is a resource available in any surgery service today, which can allow checking intestinal viability in a safe and non-aggressive way for patients.
Inguino-crural hernia surgery is a frequent pathology in emergency surgery. Incarcerated inguinal hernia sometimes requires intestinal resection. This situation sometimes depends on the surgeon's experience. The aim of this work was to propose the performance of a low pressure laparoscopy, through the hernial orifice, to visualize the released intestinal loop and its correct recovery after its reintroduction into the abdominal cavity.
Methods:
Most of our patients with incarcerated hernia have several pathologies, so urgent intervention is performed under spinal anesthesia. Since 2015, if during the intervention the intestinal loop was reintroduced without verifying its complete recovery or if there were doubts about it, a laparoscopy was performed through the hernial orifice, to verify the viability of the intestinal loop.
Results:
In the last 6 years, 8 patients undergoing emergency surgery under spinal anesthesia due to incarcerated inguinal or femoral hernia were collected. A "hernioscopy" was performed through the hernial orifice sac, in order to identify the intestinal loop once it had been reduced. A 10 mm optical trocar was inserted with the video endoscope and CO2 was injected at a low pressure of 4-6 mmHg. Complete recovery of the intestinal loop was verified in all cases. The trocar and gas were removed. The hernial sac was closed and the hernia was repaired using low-density mesh according to standard techniques.
CONCLUSION(S): In our series it was possible to see the bowel loops of the 8 patients, allowing their adequate treatment, without complications and with an early discharge from hospital. If it had not been visualized, the patient would have been admitted for observation for an additional 24 - 48 hours, or complementary studies such as analytics or imaging tests would have been performed. Hernioscopy is a resource available in any surgery service today, which can allow checking intestinal viability in a safe and non-aggressive way for patients.
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