Although no final conclusion can be made regarding the presumed non-inferiority of this technique in terms of recurrence and mesh infection compared with traditional laparoscopic IPOM, laparoscopic-assisted transvaginal IPOM is a feasible alternative to treat abdominal wall hernias.

This is a video submission for an interesting caseA 66 year-old lady was previously repeated admitted for vomiting and aspiration pneumonia. EGD showed a suspected hiatal hernia with gastric volvus. Endoscopic reduction was performed and the patient was scheduled for operation. Intra-operatively, it was noted that there were no hiatal hernia but a left diaphragmatic hernia was present. The hernial contents were reduced and the sac excised. The diaphragmatic defect was then closed primarily and reinforced with a 10 x 10cm biological mesh. An anterior partial fundoplication was also performed and the hiatus was closed.