Abstract
De Garengeot hernia, characterized by appendiceal incarceration within a femoral canal hernia sac, is a rare condition with high risks of strangulation. Traditional open repair remains standard, but laparoscopic approaches offer minimally invasive alternatives. However, limited evidence exists on combining laparoscopic transabdominal preperitoneal (TAPP) with biologic mesh for this condition. This study presents a case of laparoscopic TAPP with biologic mesh for De Garengeot hernia with concomitant laparoscopic appendectomy. A 69-year-old woman presented with a right inguinal mass and pain. Imaging confirmed a femoral hernia containing the inflamed appendix. Laparoscopic exploration revealed ischemic appendiceal changes, necessitating appendectomy. Laparoscopic TAPP with biologic mesh was performed, utilizing keyhole fixation and reinforced closure. Postoperative recovery was uneventful, as evidenced by no recurrence at 18-month follow-up. Laparoscopic TAPP with biologic mesh represents a feasible, minimally invasive strategy for De Garengeot hernia, enabling simultaneous appendectomy and hernia repair. This approach leverages the regenerative properties of biologic scaffolds and their superior anti-infective properties, while minimizing complications, offering a promising alternative to traditional methods. Further research is needed to establish standardized protocols and assess long-term outcomes.