AB001. SOH26AB_0100. When appendix meets hernia: laparoscopic transabdominal preperitoneal repair for Amyand’s hernia—a case report

Background: An Amyand hernia, defined as the presence of the appendix within an inguinal hernia sac, is a rare clinical entity encountered in approximately 1% of inguinal hernias. Surgical management depends on the condition of the appendix and the degree of contamination. Laparoscopic transabdominal preperitoneal (TAPP) repair allows simultaneous assessment of intra-abdominal structures and safe reduction of hernia contents. This video abstract describes a combined laparoscopic TAPP repair and laparoscopic appendectomy performed for an Amyand hernia involving a mildly inflamed appendix.

Case Description: A 59-year-old gentleman presented with painful right inguinal swelling for 3 days. He had a history of open left inguinal hernia repair. On examination tender, irreducible lump in the right inguinal area. Diagnostic laparoscopy confirmed an Amyand hernia with a partially inflamed but non-perforated appendix. After reducing the content, laparoscopic TAPP repair with mesh was performed for the hernia. Laparoscopic appendectomy was performed after hernia repair. The procedure was completed laparoscopically without intraoperative complications. There was no spillage or gross contamination during the appendectomy, permitting the safe placement of synthetic mesh. The patient exhibited an uneventful postoperative recovery and tolerated early oral intake. The patient was kept for intravenous antibiotics for 5 days and discharged home on oral antibiotics for 2 weeks. No wound infection, mesh-related complications, or early recurrence was observed at short-term follow-up.

Conclusions: Laparoscopic TAPP mesh repair with laparoscopic appendectomy represents a safe and effective approach for selected Amyand hernias where the appendix is inflamed but nonperforated. This strategy allows optimal visualisation, controlled removal of the appendix, and durable hernia repair using mesh in a minimally contaminated environment. The laparoscopic approach offers advantages in postoperative recovery, reduced pain, and comprehensive inspection of the abdominal cavity, supporting its use in appropriate cases.

Keywords: Amyand hernia; acute appendicitis; inguinal hernia; mesh repair; case report