Single-incision laparoscopic total extraperitoneal repair for a Grynfeltt hernia: a case report

Abstract

IntroductionA superior lumbar hernia, which is also known as a Grynfeltt hernia, is a rare abdominal wall defect that can be primary or secondary to trauma or orthopedic surgery. The anatomic location of a lumbar hernia makes diagnosis and repair challenging. We successfully repaired a lumbar hernia using a single-incision laparoscopic total extraperitoneal approach. To the best of our knowledge, this is the first report of the use of this surgical technique in the treatment of a primary Grynfeltt hernia.Case presentationA 76-year-old Taiwanese man presented to our hospital with a left lower bulging mass noted for over three months. Abdominal computed tomography revealed a left Grynfeltt hernia. We performed a single-incision laparoscopic total extraperitoneal repair. Our patient was discharged uneventfully on the fourth day after the operation. There was no evidence of recurrence after six months of follow-up.ConclusionA laparoscopic total extraperitoneal repair for a lumbar hernia provides an excellent operative view and minimal invasiveness. The single-incision technique also provides better cosmetic outcomes. Our experience suggests that the single-incision laparoscopic total extraperitoneal approach may be a feasible and safe alterative to conventional approaches in lumbar hernia repair.

Sublay repair for primary superior lumbar hernia with the Kugel patch

“…However, same with other marginal external hernias, superior lumbar hernias are difficult to repair . Due to the extremely low morbidity, most reports of superior lumbar hernia are case reports or retrospective case studies with only a few patients enrolled . Accordingly, many controversies regarding superior lumbar hernia repair exist due to the lack of large prospective case–control studies.…”