RESUMO
Femoral hernias commonly present as an emergency with a large proportion strangulated or with contents that are threatened. Many surgical options are available including minimally invasive surgery and multiple open approaches. A low approach allows a relatively simple repair of the hernia and has a long-established history of safety with reproducible outcomes and low recurrence rates. It is technically less challenging than a high approach but does not allow easy assessment or management of hernia sac contents. We highlight and describe a technique that can be used when the hernia reduces spontaneously at induction, or when the surgeon cannot be confident that the contents are viable. Hernioscopy is the technique of utilizing a laparoscope inserted via the hernia sac to either examine the abdominal contents or facilitate the safe creation of pneumoperitoneum and further insertion of ports transabdominally when the patient has pelvic adhesions. We describe the operative steps taken to make this a feasible approach and reduce the need for unnecessary laparotomies and the associated morbidity.
RESUMO
Loin pain hematuria syndrome (LPHS) is a rare idiopathic condition. LPHS can present with both unilateral and bilateral loin pain, microscopic or macroscopic hematuria. It is a diagnosis of exclusion. The management options for this condition include pain management with narcotics or opioids, renal denervation, kidney autotransplantation and neurectomy or nephrectomy. However, these treatment modalities are the last resort.
