To explore the clinical efficacy and technical challenges of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) in treating incarcerated femoral hernias.

A retrospective analysis was conducted on 24 patients with incarcerated femoral hernia treated with TAPP at the Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2018 to October 2021. Clinical data that intraoperative findings and management methods, surgical-related indicators (operative time, intraoperative blood loss, length of hospital stay), postoperative complications (wound infection, seroma formation, mesh infection), and recurrence rate, were analyzed.

All 24 patients successfully underwent TAPP treatment. Of these, 22 patients had their hernia contents completely reduced laparoscopically, while 2 required an auxiliary small incision to reduce the incarcerated hernia contents due to initial inexperience. In 11 patients, there was an intestinal incarceration; out of which, 4 cases failed in manual reduction. During the procedure, the iliopubic tract was incised using an electrosurgical hook to reduce the small intestine. Subsequent examination revealed that the reduced incarcerated intestine had no damage or necrosis. During the exploratory procedure of 4 patients, a concealed hernia was discovered. Three of these patients underwent TAPP surgery for bilateral femoral hernias. One patient, aged 90, did not undergo simultaneous repair of the concealed hernia to reduce anesthesia time and surgical trauma. The surgery lasted between 45 to 150 minutes, averaging 84.87±26.10 minutes. Intraoperative blood loss ranged from 5 to 30 ml, with an average of 9.58±6.06 ml. The hospital stay varied between 2 to 15 days, averaging 6.70±3.07 days. One patient developed postoperative seroma, which improved after aspiration. Another patient faced difficulties in urination postoperatively and showed improvement after a urinary catheter was retained for 2 days. There were no cases of wound infection. Through phone follow-ups or patient revisits, during a period ranging from 3 months to 2 years, no mesh infections or hernia recurrences were identified.

The TAPP treatment method for patients with incarcerated femoral hernia is safe and effective. This method can not only reduce the need for a second surgery, but also has fewer postoperative complications.