Strangulated Internal Hernia Beneath the Obturator Nerve After Laparoscopic Radical Cystectomy With Extended Pelvic Lymph Node Dissection.

Internal hernia beneath the vascular structures after pelvic lymphadenectomy is a rare condition. Herein, we report a case of a strangulated internal hernia beneath the obturator nerve 38 months after laparoscopic radical cystectomy with extended pelvic lymphadenectomy. Computed tomography revealed dilated small bowels and a closed loop in the pelvis. The emergency laparotomy was performed, and a strangulated internal hernia beneath the obturator nerve was observed. It is necessary to consider the possibility of internal hernia beneath the vascular structure, including the obturator nerve, after the pelvic lymph lymphadenectomy, particularly via a minimally invasive approach.