Peer-reviewed veterinary case report
Surgical treatment options for obturator hernia in elderly women
By Kawashita Y et al.·2026·Fukuoka Seisyukai Hospital·View original on Europe PMC →
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Original publication title: Obturator Hernia: A Critical Appraisal of Treatment Strategies Based on 10 Cases and Current Literature: Towards a Pragmatic Surgical Algorithm.
Plain-English summary
Obturator hernia is a rare type of hernia that mainly affects older, thin women. In a study of 10 female patients, all averaging about 89 years old, emergency surgery was performed to treat this condition. Most of the patients had some part of their bowel removed, and different surgical methods were used, including open surgery and a less invasive laparoscopic technique. Unfortunately, one patient passed away after surgery due to complications, and another had a recurrence of the hernia about 34 months later after a specific type of repair. The researchers suggest a new approach to treatment that focuses on using the laparoscopic method as the first choice and considering the health of the bowel when deciding on the best repair method.
Abstract
Obturator hernia is a rare pelvic hernia that predominantly affects elderly, thin women. Despite advances in imaging and surgical techniques, the optimal surgical approach remains controversial. We retrospectively analyzed 10 patients who underwent emergency surgery for an obturator hernia at our institution between January 2010 and August 2024. All patients were female with a median age of 88.9 years (range: 84-97). Six patients (60%) required bowel resection. Seven underwent open repairs, and three underwent laparoscopic transabdominal preperitoneal (TAPP) repair. One patient with perforated peritonitis died postoperatively. During a median follow-up of 32 months (range: 18-51), one recurrence occurred at 34 months in a patient who had undergone suture repair without mesh reinforcement. Based on our experience and a comprehensive literature review encompassing three systematic reviews/meta-analyses and one nationwide registry study, we propose a treatment algorithm centered on three principles: TAPP as the default approach, bowel viability as the central decision point, and a contamination-based repair strategy. Two illustrative cases demonstrate the clinical application of this algorithm.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41728396