Laparoscopic totally extraperitoneal repair Proves Superior for Incarcerated Femoral Hernias in Women: Study

Researchers have found in a new study that laparoscopic totally extraperitoneal repair, with selective adjunct techniques, is a safe and effective option for incarcerated femoral hernias in females. The study compared laparoscopic totally extraperitoneal repair with transrectus sheath preperitoneal repair (TREPP), assessing perioperative outcomes, complication rates, and recovery. Findings indicated that the laparoscopic approach provided superior perioperative outcomes, including reduced postoperative pain, shorter hospital stays, and faster return to daily activities, especially in cases without severe bowel compromise. These results suggest that laparoscopic totally extraperitoneal repair may be the preferred surgical method for female patients with incarcerated femoral hernias.

The study analyzed data from female patients who underwent either laparoscopic totally extraperitoneal repair or TREPP at a single center. Surgical outcomes were evaluated based on operative time, intraoperative and postoperative complications, length of hospital stay, and recovery milestones. Patients receiving laparoscopic totally extraperitoneal repair experienced fewer complications and quicker recovery compared with those undergoing TREPP. The study highlighted the importance of selective adjunct techniques, such as careful reduction of herniated tissue and reinforcement of the hernia site, to optimize surgical outcomes. The minimally invasive nature of the laparoscopic approach contributed to less tissue trauma and enhanced patient comfort.
While the results support the advantages of laparoscopic totally extraperitoneal repair, the authors emphasize that patient selection is critical, particularly in cases with bowel ischemia or necrosis, which may require more extensive surgical intervention. This research adds to growing evidence that laparoscopic approaches can safely manage complex femoral hernias in women, offering improved functional recovery, shorter hospitalization, and better overall outcomes. Further multicenter studies are recommended to validate these findings and refine operative techniques for broader clinical application.
Keywords: laparoscopic totally extraperitoneal repair, incarcerated femoral hernia, transrectus sheath preperitoneal repair, TREPP, perioperative outcomes, minimally invasive surgery, adjunct techniques, female patients, Zhang A., Xu H., Huang W., BMC Surgery
Reference:
Zhang A., Xu H., Huang W., et al. 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. BMC Surgery. 2025;25:472. doi:10.1186/s12893-025-03189-w

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