There are clinical reports of inguinal hernia repair using the Direct Kugel patch^®, but femoral hernia repair using the Direct Kugel patch^® repair has not been reported previously. We presents here that incarcerated femoral hernia repair was done using the Direct Kugel patch^® after cutting the femoral ring through femoral approach.
Patient 1, a 72-year-old woman with a several-year history of sustaining swelling of the inguinal region, was referred to our hospital because of suspected incarcerated hernia in June 2007. When she was first seen, she had right inguinal swelling with tenderness. She was diagnosed as having right incarcerated femoral hernia by abdominal CTscan. On the same day, emergency operation was performed. Patient 2, a 90-year-old woman complaining of nausea, was referred to the department of medicine in our hospital for the treatment of paralytic ileus in August 2007. Two days later, abdominal CTscan showed left incarcerated femoral hernia. She underwent emergency operation. In these two cases, the incarcerated hernia was released by cutting the femoral ring through femoral approach. The hernia sac was treated by low ligation after confirmed contents of the hernia sac. After dissecting the preperitoneal cavity, we inserted a Direct Kugel patch^® into there. Their postoperative courses were uneventful and they were discharged from the hospital.