Robot Assisted Repair of Acquired Abdominal Intercostal Hernias (AIH)

Abstract

Abdominal intercostal hernia (AIH) is a rare clinical entity in which intra-abdominal visceral contents protrude through a defect between adjacent ribs. Most AIH are repaired via (an open or a laparoscopic) transabdominal approach or a thoracotomy. In this paper, the authors present two cases of AIH. Both cases of AIH developed in male patients after severe coughing episodes and demonstrated on computed tomography (CT) to include multiple abdominal viscera. In both cases, a robot-assisted laparoscopic hernia repair was performed utilizing Sepramesh and V-Lock suturing. To our knowledge, these are the first case reports of a robotic approach to repair of AIH. Both cases demonstrate the safety of this approach and expand on novel robotic approaches to ventral hernia repairs. Studies of longer term outcomes from this surgical approach are limited in the literature due to small number of cases and even fewer associated case reports.

Gastric volvulus and tension gastrothorax secondary to spontaneous transdiaphragmatic intercostal hernia

“…Spontaneous atraumatic AIHs remain a relatively rare phenomenon, with 49 cases reported in the professional literature 2–20. Almost all occurred in the context of a coughing fit.…”