Open mesh plug repair for inguinal hernia after femoro-femoral arterial bypass: Two retrospective case series

INTRODUCTION: Reports on inguinal hernia repair after femoral arterial bypass are limited, and a recommended procedure has not been established. PRESENTATION OF CASE: Case 1. A 77-year-old man who had a history of femoro-femoral arterial bypass (FFB) for limb graft occlusion following endovascular aortic repair for abdominal aortic aneurysm presented with a left inguinal hernia. CT revealed an inguinal hernia and the FFB graft was identified in the subcutaneous plane. We selected mesh-plug repair under local infiltration anesthesia and his postoperative course was uneventful. Case 2. A 73-year-old man who had a history of FFB for occlusion the branch of the graft of endovascular stent for abdominal aortic aneurysm presented with a left inguinal hernia. CT revealed an inguinal hernia and the FFB graft was identified in the subcutaneous plane. We performed mesh-plug repair under general anesthesia and his postoperative course was uneventful. The patients are free of recurrence of the hernia or complication of the FFB graft as of 13 months and 30 months after the surgery, respectively. DISCUSSION: We herein report two cases of successful open mesh plug repair for inguinal hernia after FFB. CONCLUSION: The mesh plug repair is safe and useful for the treatment of inguinal hernia after FFB, for which preoperative CT is helpful for understanding precise anatomy which facilitates surgical planning.