The purpose of this study was to investigate the clinical efficacy of laparoscopic lacunar ligamentotomy in the treatment of irreducible incarcerated femoral hernias.

Clinical data of patients with incarcerated femoral hernia treated by laparoscopic lacunar ligamentotomy in the First People's Hospital of Foshan from January 2012 to August 2019 were retrospectively analyzed. Clinical data of the patients were collected, including the length of operation, intraoperative blood loss, length of stay, postoperative complications and recurrence rate.

32 patients with incarcerate femoral hernia underwent laparoscopic lacunar ligamentotomy treatment (24 of them underwent laparoscopic transabdominal preperitoneal approach, 8 of them underwent laparoscopic totally extraperitoneal approach). There were 6 men and 26 women, none of the patients experienced traumatic bowel injury during this process, no one was converted to laparotomy because of the unsuccessful reduction of incarcerated contents; 4 intestinal necrosis and 1 intestinal perforation were occurred, these patients were converted to open enterectomy, bladder injury occurred in one patient who followed by laparoscopic repair The length of operation was 45 to180 minutes [mean (101.08±43.62) minutes], the blood loss was 2 to50 ml [mean (12.3±8.5) ml], and the hospital stay was 3 to 15 days [mean (5.31±2.96) days). There were 22 cases of subcutaneous emphysema, 13 cases of seroma, 1 case of wound infection which was cured by dressing change, and 1 case of postoperative adhesive intestinal obstruction improved by conservative treatment. The follow-up period was from 6 to 48 months, recurrent indirect inguinal hernia occurred in 1 patient and no mesh infection.

Laparoscopic lacunar ligamentotomy in the treatment of incarcerated femoral hernias can effectively avoid traumatic bowel injury and reduce the rate of conversion to laparotomy and recurrence.