Grynfelt-Lesshaft hernia a case report and review of the literature

Abstract

IntroductionLumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life.Case reportA 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type “A” lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO® mesh fixed with PDS® II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication.DiscussionPrimary (spontaneous) lumbar hernias represent 50–60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH.ConclusionThe surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

Abordaje laparoscópico de la Hernia de Grynfelt. Reporte de caso

“…Su origen puede ser congénito en el 20% de los casos y adquirido en el 80% restante, subdividiéndose este último, en un tipo espontáneo (primario) en el 50-60 % de los pacientes y un tipo secundario, generalmente en relación a lesiones traumáticas (8).…”

“…Existen múltiples sistemas de clasificación para las hernias lumbares; sin embargo, en la actualidad una de las clasificaciones más utilizadas es la de Moreno-Egea que las divide en 4 tipos (A-D) teniendo en cuenta el tamaño, la localización, el contenido, la etiología, la presencia de atrofia muscular y la recurrencia (tabla 1); según los resultados sugiere el mejor abordaje terapéutico, abierto o laparoscópico, para cada tipo de paciente (8).…”

Bone anchor fixation method of an incarcerated Petit hernia in an elderly lady: Optimal management of a rare case

“…The different available repair options that have been reported in addition to bone anchor fixation include using local tissue and fascia flaps, primary mesh closure, and double layer mesh repair, with each method having various reports of successful outcomes with respect to rate of hernia recurrence and operative complications. [17][18][19] Nonetheless, specific selection criteria for any of the aforementioned methods over the other are nonexistent. [8] In our case, we decided to perform repair using bone anchor fixation because in addition to reports of successful outcomes (see Table 1), using structural support of neighboring bone may have provided superiority in stability of the repair over other methods.…”

Sublay repair for primary superior lumbar hernia with the Kugel patch

“…Superior lumbar hernia, also called Grynfeltt hernia, refers to a hernia that protrudes through the superior lumbar triangle in the lumbar region . The superior lumbar triangle (Grynfeltt's triangle) is superiorly bound by the 12th rib and inferior posterior serratus muscle, medially bound by the erector spinae muscle, and laterally bound by the internal oblique muscle.…”