Page 48 - World Journal of Laparoscopic Surgery

A Minimally Invasive Procedure to Evaluate Bowel Viability

Fig. 1: 12 mm laparoscopic port inserted into the peritoneal cavity via Fig. 2: Laparoscopy showing a segment of entrapped small bowel with
the femoral canal visible constriction markings
They demonstrated that this was a safe and useful technique in the and simple and can prevent unnecessary laparotomies and their
treatment of such cases. associated complications.
4
Romain et al. assessed the prognostic factors associated with
postoperative morbidity and mortality following strangulated groin clinicAl significAnce

hernia repairs. They compared explorative laparotomy, laparoscopy,
and hernioscopy and noted that explorative laparotomy was a major There have not been sufficed case reports on this technique for
cause of postoperative complications. a formal case series to be undertaken to look into the precise
Potential drawbacks of this technique include inadequate complications of femoral hernioscopy postoperative and long-term
mobilization of bowel necessitating the introduction of additional follow-up. We feel this is a cornerstone in application of minimal
ports. However, this problem can be addressed by the use of a access surgery for a common general surgical emergency, and
SILS port. In addition, in some cases, views may be obscured in hence further research with the application of this technique is
the presence of dense intra-abdominal adhesions or gross ascites. required in this field.
Nevertheless, hernioscopy without additional trocar placement
is a valuable technique that can be utilized by skilled and references
experienced laparoscopic surgeons to prevent unnecessary 1. Morris-Stiff G, Hassn A. Hernioscopy: a useful technique for the
4,5
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reduced risk of infection, postoperative pain, length of stay, wound 2. Kneesy K, Weinbaum F. Hernioscopic retrieval of bowel for
dehiscence, incisional hernias, earlier mobilization, and reduced evaluation of viability during repair of a Richter’s-type incarcerated
thromboembolic events. femoral hernia. Surg Laparosc Endosc 1997;7(2):171–172. DOI:
In addition, inspection via the laparoscope may provide 10.1097/00019509-199704000-00023.
additional useful information such as the presence of ascitic fluid 3. Valderrama AR, Ruiz D, Malik M, et al. Femoral hernia sac laparoscopy:
a case report. Minim Invasive Ther Allied Technol 2014;23(1):55–57.
or tumors. DOI: 10.3109/13645706.2013.831108.
4. Romain B, Chemaly R, Meyer N, et al. Prognostic factors of
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Hernia 2012;16(4):405–410. DOI: 10.1007/s10029-012-0937-y.
In situations where the contents of a hernial sac have reduced 5. Lin E, Wear K, Tiszenkel HI. Planned reduction of incarcerated groin
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the use of hernioscopy. In skilled hands, the technique is safe DOI: 10.1007/s00464-001-8242-3.

134 World Journal of Laparoscopic Surgery, Volume 12 Issue 3 (September–December 2019)