A 73-year-old man presented to the emergency room with right groin pain and a bulge. The patient had undergone a left inguinal hernia repair with mesh three months previously. No hernia was detected on the right side at that time. Partial reduction of the groin mass was accomplished with difficulty in the emergency room. The patient complained of abdominal pain after reduction but there was no localized tenderness or peritoneal signs.
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The patient was taken to the operating room and a Foley catheter was placed. Right groin exploration revealed a small direct defect with a significant amount of bladder protruding through the inguinal floor on the medial side of the defect. The transversalis fascia and peritoneum composing the sac were opened lateral to the bladder. The bladder was reduced, leaving a 2.5-cm defect. Because the bowel that had been in the direct sac was no longer present, it was elected to do laparoscopic exploration through the hernia defect. A 16 Fr. red rubber Robinson catheter was inserted into the peritoneum through the sac.
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