Laparoscopic Technique in the Management of Spigelian Hernia

Abstract

Spigelian hernias are uncommon, and preoperative diagnosis is often difficult. The use of the laparoscope has simplified the diagnosis and subsequent repair of these rare hernias. We report a case diagnosed and repaired using laparoscopic techniques of fascia approximation, mesh reinforcement, and reperitonization.

Spigelian Hernia: Case Series and Review of the Literature

“…In the past 20 years, the laparoscopic approach has become much more common. Laparoscopy has the advantage of offering nearly 100% diagnostic accuracy [11]. There are two broad approaches to laparoscopic repair of SH, i.e.…”

“…At the 12-month follow-up, no complications or recurrence were noted. 10 studies in our literature review describe closure of the fascial defect in larger hernias prior to placement of the mesh in the intraperitoneal approach [20,21,22]. However, Barnes et al [18] published a case series of 26 patients in which closure of the fascial defect was purposefully omitted during intraperitoneal repair.…”

Laparoscopic Spigelian and Inguinal Hernia Repair With the Kugel Patch

“…9 Once a diagnosis of Spigelian hernia is confirmed, open surgery is the most common approach used for repair. However, laparoscopic procedures (preferably TEP or intraperitoneal approaches) are often used [10][11][12][13] when surgical repair of simultaneously occurring unilateral Spigelian and inguinal hernias is planned, as in the present case and as previously reported. 14-15 Therefore, we first used a TEP approach to repair the hernia, which involves the preperitoneal placement of mesh with nonabsorbable fixation in a tension-free manner without peritoneal repair.…”

Spigelian hernia: rare so, beware!

“…Presently, CT with thin sections is considered most reliable in doubtful cases. 2 These hernias are prone to strangulation because of sharp fascial margin around the defect. Surgery can be performed either conventionally or laparoscopically.…”