Case Report: A case of suprapiriform ureterosciatic hernia with ureteral incarceration treated by total extraperitoneal laparoscopic technique

Sciatic hernias (SH) are one of the rarest forms of pelvic floor hernia. Suprapiriform sciatic hernia (SSH) is the most common type among them. We present the case of a male patient with a preoperative contrast enhanced CT urogram suggesting left ureteral incarceration due to a left ureterosciatic hernia. With the combined efforts of the general surgery and urology departments, we performed a tension-free repair of the ureterosciatic hernia using a total extraperitoneal laparoscopic approach (TEP). Additionally, the left ureter is released from the hernia sac and a double J ureteral stent placement were accomplished via transurethral ureteroscopy. Intraoperative diagnosis confirmed left suprapiriform ureterosciatic hernia with left ureteral incarceration. The double J ureteral stent was removed one month after surgery and follow up continued for 3 months, during which time the patient showed no signs or symptoms of recurrence. Therefore, total extraperitoneal laparoscopic exploration and repair can be considered a favorable treatment modality for symptomatic suprapiriform ureterosciatic hernia and other types of sciatic hernia. Especially in view of the advantages of minimal trauma, rapid recovery, better visual field, convenient observation of surrounding anatomical structures, and improved operation maneuverability.