PMC4573849_01
Preoperative computed tomography showed suspicion of bilateral inguinal hernia.
gr1.jpg
PMC4573849_01_gr1.jpg
fig0005
Abdominal computed tomography (CT) demonstrated marked and mild protrusion of peritoneum at right and left inguinal region, respectively (Fig. 1).
Right hernia orifice was located was located on the medial umbilical ligament (thick arrow, hernia orifice; thin arrow, medial umbilical ligament; arrowhead, inferior epigastric vessels) (A, B), and a mild protrusion of peritoneum at the medial of inferior epigastric vessels at the left inguinal region (arrow, hernia orifice of the left side) (C).
gr2.jpg
PMC4573849_01_gr2.jpg
fig0010
It was also identified that a mild protrusion of peritoneum at the medial of inferior epigastric vessels at the left inguinal region (Fig. 2). Especially as for the right-side hernia, the marked one, the hernia orifice was located on the medial umbilical ligament (Fig. 2).
Intraoperative findings of the dissection of right inguinal hernia. Dissection layer of the right one reached the dorsal site of urine bladder (arrow, urine bladder; arrowhead, Cooper ligament) (A, B). A covering material of a mesh was put on the hernia orifice (C).
gr3.jpg
PMC4573849_01_gr3.jpg
fig0015
The right-side peritoneal dissection of hernia orifice was performed toward the dorsal site of urine bladder (Fig. 3), and a mesh (Bard  3D Max Light, M size\) was put on the dissected space \(Fig. 3).
Dissection layer of the left one also reached the dorsal site of urine bladder (arrowhead, Cooper ligament; arrow, a mesh put on the opposite side) (A, B).
gr4.jpg
PMC4573849_01_gr4.jpg
fig0020
During dissection of the right inguinal hernia, the dissected layer of the dorsal site of urine bladder was connected with the right one (Fig. 4).