Introduction: Acute inguinal hernias are a common presentation as surgical emergencies, which have been routinely managed with open surgery. In recent years, the
laparoscopic approach has been described by several authors but has been controversial amongst surgeons. We
describe the laparoscopic approach to incarcerated/strangulated inguinal hernias based on a review of the literature with regards to its feasibility in laparoscopically managing the acute hernia presentation.
Methods: A systematic literature search was carried out
including Medline with PubMed as the search engine, and
Ovid, Embase, Cochrane Collaboration, and Google
Scholar databases to identify articles reporting on laparoscopic treatment, reduction, and repair of incarcerated or
strangulated inguinal hernias from 1989 to 2008.
Results: Forty-three articles were found, and 7 were
included according to the inclusion criteria set. Articles
reporting on the use of laparoscopy for the evaluation
of the hernia but not reducing and repairing it, the use
of the open technique, elective hernia repairs, pediatric
series, review articles, and other kinds of hernias were
excluded after title and abstract review. This resulted in
16 articles that were reviewed in full. Of these 16
articles, 7 reported on the use of the laparoscopic approach exclusively. From these 7 studies, there were
328 cases reported, 6 conversions, average operating
time of 61.3 minutes (SD 12.3), average hospital stay
of 3.8 days (SD 1.2), 34 complications (25 of which
were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically.
Conclusion: The laparoscopic repair is a feasible procedure with acceptable results; however, its efficacy needs