Robotic repair of symptomatic Spigelian hernias: a series of three cases and surgical technique review

Jamshidian, Mitra; Stanek, Stephen; Sferra, Joseph; Jamil, Tahir

doi:10.1007/s11701-017-0742-9

Cited by 19 publications

(23 citation statements)

References 6 publications

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“…It has been reported that the long-term recurrence rate may be lower with mesh than with simple suture closure [ 9 ]. In recent years, laparoscopic surgery including robotic surgery has been increasingly used in reported cases of Spigelian hernia [ [13] , [14] , [15] , [16] , [17] ]. In the present study, we did not use the inexpensive transabdominal preperitoneal approach (TAPP) method, but rather the IPOM method, which we usually use for abdominal wall scar hernias at our hospital, in case 1.…”

Section: Discussionmentioning

confidence: 99%

The advantage of laparoscopic surgery in the treatment of Spigelian hernia: A report of two cases

Takayama

Okada

Nakatani

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance The usefulness of laparoscopic surgery in the treatment of Spigelian hernias and the appropriate insufflation pressure remains unclear. Case presentation Case 1 involved an 81-year-old woman presented with a right abdominal protrusion. CT scan demonstrated a defect in the abdominal wall at the lateral edge of the right rectus abdominis muscle. We diagnosed as Spigelian hernia and performed laparoscopic hernia repair. The insufflation pressure was set at 10 cm H 2 O, and the IPOM method was selected as the repair method. Case 2 involved a 74-year-old male presented with a right abdominal painful bulging. Strangulation was released and CT scan demonstrated a defect in the abdominal wall at the lateral edge of the right rectus abdominis muscle. We diagnosed as Spigelian hernia and performed laparoscopic hernia repair. The insufflation pressure was set at 10 cmH 2 O, and the repair was performed by the hybrid method. Clinical discussion In both cases, the positions of the hernia portals marked preoperatively based on the tender areas and confirmed laparoscopically were not accurate. Although Spigelian hernia is a rare disease and various laparoscopic techniques have been reported in recent years, laparoscopic surgery is very useful to obtain an accurate diagnosis and to observe the abdominal wall from inside the abdominal cavity under insufflation, and it is better to decide the repair method according to the situation of each case and institution. Conclusion Laparoscopic surgery is important for accurate diagnosis in surgery of Spiegel's hernia, and insufflation pressure of 10 cmH2O was sufficient.

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Section: Discussionmentioning

confidence: 99%

The advantage of laparoscopic surgery in the treatment of Spigelian hernia: A report of two cases

Takayama

Okada

Nakatani

et al. 2021

International Journal of Surgery Case Reports

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“…Patients reported minimal pain and hospitalization was no longer than overnight admission. 10 Follow up, regarding the recurrence rate, for these three cases was not reported. Pirolla et al compared two cases of robotic repair to three cases of laparoscopic spigelian hernia repair.…”

Section: Discussionmentioning

confidence: 95%

“…Most commonly, contents of the hernia include omentum or intestine; others, however, contain ovary, fallopian tube, uterus, testis, gallbladder, stomach, Meckel's diverticulum, appendix, and bladder. 8,10…”

Section: Discussionmentioning

confidence: 99%

Chronic Abdominal Pain In A Geriatric Patient: A Rare Case Of A Spigelian Hernia

Wright¹,

Dayo²,

Goebel³

2020

Marshall Journal of Medicine

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We present a case of spigelian hernia in a 77-year-old patient to highlight the difficulty in making this diagnosis and to raise awareness of this rare condition among physicians who care for geriatric patients with chronic bouts of abdominal pain. The patient presented to the emergency department with a two-day complaint of abdominal pain after three years of similar recurrent attacks. Results of the physical examination and computed tomography (CT) of the abdomen were consistent with a left-sided spigelian hernia. Operative repair was performed using robotic-assisted reduction and the patient recovered without any complications.

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“…Todas las opciones presentan buenos resultados clínicos, pero aún no contamos con estudios que puedan sacar conclusiones definitivas sobre cuál es la mejor técnica de abordaje, principalmente por la rareza de este proceso y por la falta de revisiones sistemáticas, excluyendo los trabajos publicados por Moreno-Egea, único estudio aleatorizado existente hasta la fecha 7,9,11 . Sobre la posibilidad de emplear el acceso por robótica, apenas hay documentación, aunque parece que podría tener algo de ventaja en el periodo de recuperación más corto y en una mayor precisión durante la técnica con menor riesgo de sangrado 12 , aunque todavía no pueda concluirse nada.…”

Section: Discussionunclassified

Hernia de Spiegel tras incisión de Pfannestiel: hipótesis etiopatogénica y revisión de la literatura

Funes

Sánchez²,

Jiménez³

2018

Rev Hispanoam Hernia

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ResumenIntroducción: La hernia de Spiegel es un tipo de hernia lateral de la pared abdominal poco frecuente. Una vez se diagnostica es conveniente intervenir por el alto riesgo de complicación.Caso clínico: Presentamos una paciente con antecedente de fi brilación auricular anticoagulada con apixaban. Consultó en Urgencias con signos y síntomas de obstrucción intestinal y se confi rmó la sospecha diagnóstica por tomografía de abdomen: hernia de Spiegel izquierda incarcerada. Se espero 24 horas para garantizar el consumo del anticoagulante para evitar el alto riesgo de sangrado y no 48 h, como se recomienda por el fármaco, para evitar en lo posible la evolución de la lesión y una posible perforación intestinal. El abordaje se realizó vía laparoscópica con técnica IPOM para evitar sangrados masivos por el menor trauma parietal. La paciente no presentó complicaciones. A los 12 meses permanece sin recurrencias.Discusión: Nuestro caso plantea un dilema de tratamiento médico. La paciente tiene un alto riesgo de necrosis y perforación intestinal en caso de no ser intervenida, pero también la cirugía representa un riesgo de sangrado por estar anticoagulada con apixaban (Eliquis ® ), medicamento que no tiene antídoto para revertir su efecto. Se considera que el riesgo de perforación o necrosis es mayor al de sangrado y se interviene con 24 h de latencia (no 48 h). Se decide abordaje laparoscópico porque para nosotros es el que menor riesgo de sangrado presenta. Palabras clave:Hernia de Spiegel, tratamiento, laparoscopia, anticoagulantes. AbstractIntroduction: Spiegel's hernia is a rare type of lateral hernia on the abdominal wall. Once it is diagnosed, it may be convenient to undergo surgery because of the high risk of complications.Case report: We present the case of a patient with history of atrial fi brillation anticoagulated with Apixaban. She went to the emergency department with signs and symptoms of intestinal obstruction. The diagnose was confi rmed by abdominal tomography: Incarcerated left Spiegel hernia. We decided to wait 24 hours to ensure the anticoagulant clearance, with the idea of avoiding the risk of bleeding in surgery; we considered not to wait 48 hours as recommended by the drug guidelines, avoiding as far as possible the progression of the disease and preventing a possible intestinal perforation. To prevent massive bleeding due to less parietal trauma the approach was performed laparoscopically with the IPOM technique. The patient did not present complications on surgery and 12 months later it remains without recurrence of illness.Discussion: Our case shows a dilemma of medical treatment, the patient had a high risk of necrosis and intestinal perforation in case of not being operated, but also surgery represents a risk of bleeding due to being anticoagulated with Apixaban (Eliquis ® ), a medicine that does not have antidote to reverse its effect. We considered that the risk of perforation or necrosis was greater than the risk of bleeding, that is why we decided that the surgical process should be made...

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Robotic repair of symptomatic Spigelian hernias: a series of three cases and surgical technique review

Cited by 19 publications

References 6 publications

The advantage of laparoscopic surgery in the treatment of Spigelian hernia: A report of two cases

The advantage of laparoscopic surgery in the treatment of Spigelian hernia: A report of two cases

Chronic Abdominal Pain In A Geriatric Patient: A Rare Case Of A Spigelian Hernia

Hernia de Spiegel tras incisión de Pfannestiel: hipótesis etiopatogénica y revisión de la literatura

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