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Comparison of laparoscopic totally extraperitoneal repair with adjunct techniques and open surgery (TREPP) in female patients with incarcerated femoral hernia: a single-center retrospective cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: Incarcerated femoral hernia often requires urgent surgical intervention, yet the optimal approach remains debated. Open surgery—particularly the transrectus sheath preperitoneal procedure (TREPP)—is commonly used, while laparoscopic totally extraperitoneal (TEP) repair is gaining traction. This study aimed to evaluate the clinical outcomes of laparoscopic TEP with adjunct techniques (aTEP) versus TREPP in female patients with incarcerated femoral hernia. METHODS: This was a single-centre, retrospective, comparative study conducted at the Shenzhen People’s Hospital between January 2020 and December 2023. Female patients with incarcerated femoral hernias who underwent either aTEP or TREPP were included. The aTEP technique involved a standard laparoscopic TEP repair with the addition of a small femoral ring incision, and final laparoscopic observation through the umbilicus to assess bowel viability. Surgical approach was determined based on clinical presentation, patient condition, and surgeon judgment. Baseline characteristics and intra-/postoperative outcomes were compared between groups. RESULTS: The study included 42 patients, with 22 in the TREPP group and 20 in the aTEP group. The aTEP group demonstrated significantly better outcomes in several metrics, including shorter operative time, less intraoperative hemorrhage, lower pain scores at 24 h and postoperative day 7, reduced analgesic use, and shorter hospital stays. CONCLUSION: Laparoscopic TEP, when supplemented with selective adjunct techniques, is a safe and effective surgical option for incarcerated femoral hernias in females. Compared with TREPP, it offers improved perioperative outcomes and faster recovery, particularly in patients without severe bowel compromise. CLINICAL TRIAL NUMBER: Not applicable.

Source: BMC Surgery

DOI: 10.1186/s12893-025-03189-w

Authors: An Zhang, Haisong Xu, Wenhao Huang, Peng Zhang, Yuehua Guo, Tianchong Wu

Institutions: Jinan University, ShenZhen People’s Hospital, Southern University of Science and Technology

Language: English

Topic: Hernia repair and management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090