LAUSR

Highlights • De Garengeot’s hernia is a rare type of femoral hernia containing the vermiform appendix. The findings of an incarcerated inflamed appendix within the hernia sac is a very rare phenomenon.• Due to its rarity, there is no standard surgical approach to the appendicectomy and femoral hernia repair. Infact multiple approaches have been described in the literature. Approaches include an open approach, a combined open and laparoscopic approach or an entire laparoscopic approach. Decision making is multifactorial and is dependent on anatomy, intraoperative findings, patient co-morbidities and local expertise.• Combining an low open inguinal approach followed by a laparoscopic appendicectomy is a feasible approach in the management of De Garengeot’s hernia. An initial open inguinal approach allows you to assess the hernia sac contents and avoid additional incisions if both the hernia repair and appendectomy can be safely carried out through the incison. If further incisions are required to carry out the appendectomy, a hybrid laparoscopic may be advantageous.