Laparoscopic Management of Strangulated Inguinal Hernia

Who would be happy to approach a strangulated inguinal hernia by direct access after two open repairs. Best option for these cases would be reduction + TAPP hernia repair.Prosthesis choice will depend on the degree of the risk of infection: when there is a high probability of infection an absorbable mesh should be used. When there is a low risk of infection, absorbable ones should be okay. In a case of peritoneal breach, a double faced mesh could be used.Advantages of laparoscopic surgery in this case:- Full inspection of the peritoneal cavity, given that many of these patients are elderly.- It gives the opportunity for a warm bath off the suffering intestine and makes sure of its viability...- It gives the chance for a definitive hernia repair, low risk of recurrence.- If reception of a necrotic bowel is needed can be realised by slightly enlarging the umbilical incision to exteriorise the bowel.Groin hematoma or seroma must be expected. It requires only observation, unless voluminous.