A case report of elective operation following noninvasive reduction of obturator hernia.

Funato, Takashi; Ichihashi, Masayoshi; Inui, Hiroshi; Tarao, Makoto; Goto, Akihiko

doi:10.5833/jjgs.23.810

Cited by 14 publications

(4 citation statements)

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“…It is performed using real-time sonographic guidance in the emergency department and is based on previous reports. [8][9][10][11] This technique requires 2 surgeons, which is why it is referred to as the 4-hand technique. Before initiating this procedure, the presence of an obturator hernia (a hernial sac between the adductor longus and pubis) must be confirmed.…”

Section: Steps Used For Frogsmentioning

confidence: 99%

“…[1] Previous reports have described successful manual reductions of obturator hernias. [8–11] However, these were case reports with no statistical confirmation of the efficacy of manual reduction. Therefore, until recently, there has been no controversy regarding whether manual reduction (with or without elective surgery) or emergency surgery was more effective.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of 4-hand reduction for obturator hernia with the guidance of sonography as a new treatment strategy: A retrospective study

Togawa

Kamihata²,

Nagahisa

et al. 2022

Medicine

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To evaluate the effectiveness of 4-hand reduction for obturator hernia with the guidance of sonography (FROGS) as a new treatment strategy for obturator hernia. Since November 2019, FROGS was performed for all patients with obturator hernia at our emergency department. We retrospectively compared the clinical data of 20 patients who underwent FROGS (after FROGS group) to those of 23 patients who did not (before FROGS group). All patients except one were female. The male-to-female ratio, age, duration of symptoms, lesion site, and predisposing factors did not significantly differ between groups. However, the diameter of the prolapsed bowel and the body mass index of the after FROGS group were significantly larger and lower, respectively. Manual reduction was successfully performed for all 20 patients in the after FROGS group, and bowel resection was avoided for all 20 cases. However, 14 patients in the before FROGS group underwent manual reduction; of these, only one was successfully treated using a method other than FROGS, and 8 patients underwent bowel resection. There were no significant differences between groups in terms of postprocedural complications or mortality within 30 days of hernia presentation. The FROGS technique was safe and reproducible and could be used as the first choice of treatment for patients with obturator hernia.

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Section: Steps Used For Frogsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of 4-hand reduction for obturator hernia with the guidance of sonography as a new treatment strategy: A retrospective study

Togawa

Kamihata²,

Nagahisa

et al. 2022

Medicine

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show abstract

“…However, once diagnosed, emergency surgery is usually performed because delayed treatment can lead to intestinal ischemia and subsequently, perforation [1]. Few reports have described a successful manual reduction of obturator hernia [8][9][10]. There is no controversy about whether manual reduction (with or without elective surgery) or emergency surgery is more effective, since many general surgeons believe that emergency surgery is the only effective treatment for this condition.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Four-Hand Reduction for Obturator Hernia with the Guidance of Sonography (FROGS) As a New Treatment Strategy for Obturator Hernia: A Single-Center Study

Togawa¹,

Kamihata²,

Nagahisa³

et al. 2021

Preprint

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Background Obturator hernia is an uncommon but important cause of intestinal obstruction. Delayed treatment can be fatal. Emergency surgery is considered the most effective treatment; however, patients with obturator hernia usually have comorbidities, which precludes them from emergency surgery. This study aimed to evaluate the effectiveness of Four-hand Reduction for Obturator hernia with the Guidance of Sonography (FROGS) as a new treatment strategy for obturator hernia. Methods Since November 2019, we have tried FROGS in all patients with obturator hernia at the emergency room. All the patients were female. We retrospectively compared the clinical data of 14 patients who underwent FROGS (after-FROGS group) with those of 23 patients who did not (before-FROGS group). Results No significant differences were observed in age, lesion side, duration of symptoms, the diameter of the prolapsed bowel, and predisposing factors. The body mass index was significantly lower in the after-FROGS group than in the before-FROGS group. Manual reduction was successfully performed in all 14 patients in the FROGS group, whereas in the before-FROGS group, 14 patients underwent manual reduction, of whom only one was successfully treated using the non-FROGS method. Bowel resection was avoided in all 14 patients in the after-FROGS group, whereas 8 patients underwent bowel resection in the before-FROGS group. There were no significant differences in postoperative complications and mortality within 30 days after hernia presentation between the two groups. Conclusion Manual reduction with FROGS was found to be safe and reproducible and can be the first treatment choice for obturator hernia.

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“…[1][2][3] Nevertheless, emergency laparotomy remains a common therapeutic approach. 4 Recently some less-invasive therapeutic attempts have been reported, such as noninvasive manual reduction for incarceration 5,6 or nonlaparotomy repair techniques. [7][8][9][10] We describe how we performed elective plug repair via a thigh approach after noninvasive manual reduction of an incarcerated obturator hernia in two patients.…”

Section: Introductionmentioning

confidence: 99%

Elective plug repair of an incarcerated obturator hernia by the thigh approach after noninvasive manual reduction: Report of two cases

2010

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An obturator hernia is a rare type of pelvic hernia, which can cause bowel obstruction. Despite improved imaging techniques, which can allow us to make a preoperative diagnosis, emergency laparotomy is still often carried out. We repaired this hernia electively in two elderly women by inserting a plug into the obturator canal via the thigh, after noninvasive manual reduction. Both patients were brought to our Emergency Department after the sudden onset of severe pain in the thigh or groin. The diagnosis was confirmed by computed tomography, and manual reduction was performed immediately thereafter. Since both patients had undergone groin hernia surgery of the identical side before, less-invasive inguinal or extraperitoneal approaches were considered impossible, but laparotomy seemed too invasive. Despite being an unfamiliar field for general surgeons, the thigh approach gives excellent and easy access to the obturator canal. The technique we describe is especially useful for patients who have undergone previous groin hernia operations. We expect that this method will become a standard technique for obturator hernias without strangulation.

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A case report of elective operation following noninvasive reduction of obturator hernia.

Cited by 14 publications

References 0 publications

Evaluation of 4-hand reduction for obturator hernia with the guidance of sonography as a new treatment strategy: A retrospective study

Evaluation of 4-hand reduction for obturator hernia with the guidance of sonography as a new treatment strategy: A retrospective study

Evaluation of Four-Hand Reduction for Obturator Hernia with the Guidance of Sonography (FROGS) As a New Treatment Strategy for Obturator Hernia: A Single-Center Study

Elective plug repair of an incarcerated obturator hernia by the thigh approach after noninvasive manual reduction: Report of two cases

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