The Partial Iliopubic Tract Resection Technique for Incarcerated Femoral Hernia: A Case Series and a Literature Review.

Femoral hernias have a high incarceration rate, often necessitating urgent surgical intervention. In this report, we present a safe and reproducible laparoscopic technique for incarcerated femoral hernias with bowel involvement, including repair. Between December 2022 and May 2023, three female patients with incarcerated femoral hernias underwent urgent laparoscopic surgery. All patients presented with abdominal pain and were diagnosed with small bowel incarceration using computed tomography. Under laparoscopy, we confirmed intestinal incarceration and performed a standard transabdominal preperitoneal approach to identify the hernia defects. The iliopubic tract on the abdominal side of the hernia defect was carefully dissected using an energy device to enlarge the hernia orifice. A spontaneous reduction of the incarcerated intestine was achieved. After confirming the absence of bowel perforation, mesh was placed to repair the hernia. Following peritoneal closure, the affected part of the intestine was extracorporeally resected and anastomosed. We performed this technique on three patients, all of whom were later discharged without complications. In conclusion, for incarcerated femoral hernias with bowel obstruction, laparoscopic partial division of the iliopubic tract enables an easy, safe, and reproducible approach to incarceration release and subsequent hernia repair.