A close-up of the defect is shown. The pelvis was copiously lavaged with saline.
The dead segment of small bowel was delivered through a small right lower quadrant Rocky-Davis (transverse) incision and a functional end-to-end anastomosis was performed. The bowel was returned to the abdominal cavity and the incision closed.
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The preperitoneal space was opened with a dissecting
balloon through the umbilicus and the camera was repositioned. The obturator hernia sac was reduced. Note the pectineal (Cooper's) ligament above the defect. Inspection of the floor of the inguinal region revealed a small femoral hernia as well.
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