Abstract
Introduction:
Femoral hernias comprise <1% of all pediatric groin hernias. They are most commonly missed, with 75% being treated as reoperation. The authors present a 6-year-old boy in whom an indirect hernia was not evident, despite compelling history.
Methods:
By distracting the skin lateral and posterior to the mons pubis, an enhanced dynamic physical examination allowed clear demonstration of a defect lying medial to the iliac vessels and inferior to the iliopubic tract through laparoscopy. This approach allowed a directed McVay repair with a 2.5 cm incision. In addition, the final laparoscopic view allowed for assessment of completeness of obliteration of the space.
Conclusions:
In summary, this provocative maneuver can be employed when indirect hernias are not evident to increase sensitivity for the frequently missed diagnosis of femoral hernia.
No competing financial interests exist.
Runtime of video: 5 mins
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