[Staged bilateral total extraperitoneal allohernioplasty by e-TEP in a patient with recurrent oblique inguinal hernia on the left and combined strangulated femoral hernia on the right]. / Étapnaia dvustoronniaia total'naia ékstraperitoneal'naia allogernioplastika po metodike e-tep u patsienta s retsidivnoi kosoi pakhovoi gryzhei sleva i kombinirovannoi ushchemlennoi bedrennoi gryzhei sprava.

ABSTRACT

A case of two-stage minimally invasive surgical treatment of an elderly patient with bilateral inguinal hernia is presented a recurrent oblique on the left, combined (femoral, obturator, oblique and direct inguinal) on the right with incarceration and necrosis of the small intestine in the femoral canal. Previously, the patient underwent closure of perforated ulcer of duodenum from upper-midline laparotomy, epicystostomy, transvesical adenomectomy from the lower-midline laparotomy. The first stage we performed diagnostic laparoscopy, minilaparotomy, reduction and resection of necrotic small intestine loop. The second stage was carried endovideoscopic total extraperitoneal allohernioplasty by the method of Extended-View Totally Extraperitoneal (e-TEP) on two sides. The positive results of the treatment indicate a high efficiency of video endoscopic alloplasty of occult hernias in a complex case. To diagnose and perform adequate surgical intervention with a combined femoral hernia, when the obturator and inguinal hernias are formed, but clinically do not manifest themselves, it is possible only with endoscopic examination of potential sites of hernia formation in the inguinal region, which is not possible with open plastic hernia of the inguinal region.