Spigelian hernia: Rare or obscure?

Olson, Richard O.; Davis, W. Clayton

doi:10.1016/0002-9610(68)90453-4

Cited by 45 publications

(42 citation statements)

References 13 publications

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“…[8][9][10] In the past, preoperative diagnosis of Spiegel's hernia was performed in only 50% of cases. 11,12 The diagnoses began to be made earlier with the advent and use of ultrasonography (70% of the cases). With the advent of the computed tomography (CT) scan, especially the multislice model, diagnosis rates, when the examination is requested, can reach up to 100% of the cases.…”

mentioning

confidence: 99%

A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery

Pirolla¹,

Fregni²,

Godoy‐Santos³

et al. 2015

AHCT

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Abstract:The Spigelian hernia or Spiegel's hernia is rarely found, with less than 900 cases reported in medical literature. It was first described by J T Klinkosch in 1764 and was named by Adriaan van den Spieghel. The etiology of the hernia may be related to predisposing factors such as weakness of the abdominal wall by the insertion of vascular structures next to the semilunar or arcuate line of Douglas. However, some factors such as obesity, chronic bronchopneumopathies, and pregnancy may be associated with the etiology. Anatomically, most of these hernias occur between the lateral border of the rectus abdominis muscle and the lateral semilunar or Spigelian line that marks the transition of the transversus abdominis muscle to the aponeurosis. Spiegel's hernia can cause serious cases of organ incarceration because its diagnosis is often made at a late stage. Laparoscopic surgery is now an established method for itstreatment. We describe a surgical treatment unprecedented in the literature of Spiegel's hernia with a new procedure: the da Vinci Robotic System. This article also provides in detail the technical advantages and reliability of the robotics-assisted surgical approach on the patient. Robotics-assisted surgical repair for Spiegel's hernia has never been carried out or published previously. The authors show two cases of correction of Spiegel's hernia through surgical robotics, with the use of a mesh-type and double-sided peritoneum suture and the hernia ring suture. Advantages of the robotic approach in relation to laparoscopic technique are highlighted. A systematic review of relevant literature and the history of Spiegel's hernia are reported. The pain score was lower than that reported in pure laparoscopic surgery reports. This may be related to the increased stability of the trocar approach in robotics. It was technically easier to visualize the anterior wall and to suture this site through robotic surgery when compared to the laparoscopic approach. The robotic surgery has proven to be a procedure with significant advantages in terms of intraoperative techniques and postoperative clinical care. However, new cases should be evaluated with a larger follow-up for new conclusions.

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mentioning

confidence: 99%

A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery

Pirolla¹,

Fregni²,

Godoy‐Santos³

et al. 2015

AHCT

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“…The diagnosis of a Spigelian hernia is often difficult, as it has no characteristic symptoms, especially when there is no obvious mass, as it lies interstitially within the parietal wall. Only about 50% of cases are diagnosed preoperatively [10]. The risk of strangulation is very high, due to the shape and sharp margins of the defect, but only a few cases are reported in the literature [11].…”

Section: Discussionmentioning

confidence: 99%

Large Spigelian Hernia

S¹

2018

SMOAJ

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Spigelian hernias form a minority of all abdominal wall hernias. They occur between the layers of the abdominal wall, i.e. between the transversus abdominis and the internal oblique muscles through a small slit like or oval defect and may become incarcerated. A variety of intra abdominal organs have been reported in the hernia sac. Obstruction and strangulation are potential complications but they are rare. The clinical diagnosis of a Spigelian hernia is difficult when it is small. We present here a large Spigelian hernia which persisted for very many years without any complications.

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“…When this study was standardized the same 7.5-MHz transducer was chosen to perform all tests and obesity was not a limiting factor to obtain adequate images. Spigelian hernia is uncommon, but the classic discussion about being a poorly recognized hernia and not properly rare remains 18, 19 . It is a type of hernia rarely reported in Brazilian literature 14 .…”

Section: Discussionmentioning

confidence: 99%

Aspectos ultrassonográficos e anatomia da aponeurose do músculo transverso do abdome

Turatti¹,

Moura²,

Cabral³

et al. 2013

ABCD, arq. bras. cir. dig.

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-Background: Ultrasound, computed tomography, and magnetic resonance imaging of abdominal wall has increasingly been used for hernia diagnosis when clinical examination is uncertain. Anatomical study of abdominal wall along with the ultrasound of transversus abdominis muscle aponeurosis can help identify a Spigelian hernia in this region, a disease of difficult diagnosis. Aim: To compare the ultrasound findings of anterolateral wall of the abdomen, focusing on Spigelian aponeurosis, to the anatomy of abdominal wall studied in cadavers. Methods: The evaluation of the transversus abdominis aponeurosis was performed during routine ultrasound exams of the anterolateral wall of the abdomen in 90 individuals of both genders, over 25 years, and data were correlated with 60 dissections of the abdominal wall, held on cadavers.Results: Ultrasound showed no significant defects in the aponeurosis of transversus abdominis muscle in the 90 subjects studied and the width of the Spigelian aponeurosis ranged from 0.83 to 2.93 cm (mean 1.72 cm). During dissections of the transversus abdominis, some defects were found in 14 out of 60 muscles and aponeurosis studied (23.3%) and the width of the Spigelian aponeurosis ranged from 1.5 to 3.5 cm (mean 2.26 cm). Comparisons between age groups and genders evaluated by ultrasound with cadaver dissections performed were not statistically significant. Conclusion: Sonographic examinations found no defects in the aponeurosis of transversus abdominis muscle compatible with hernias, and anatomical variations and defects found during dissections were not as well accompanied by Spigelian hernias in the studied corpse. RESUMO -Racional:A avaliação da parede abdominal pela ultrassonografia, tomografia computadorizada e ressonância magnética tem sido cada vez mais indicada para auxiliar no diagnóstico das hérnias quando o exame clínico deixa dúvidas. A correlação de estudos da anatomia da parede abdominal com o exame ultrassonográfico da aponeurose do músculo transverso do abdome pode auxiliar no diagnóstico de uma hérnia desta localização, a hérnia de Spiegel, que se apresenta como doença de diagnóstico clínico difícil. Objetivo: Comparar os achados ultrassonográficos da parede anterolateral do abdome, com foco na aponeurose de Spiegel, e a anatomia da parede abdominal estudada em cadáveres não fixados. Método: A avaliação da aponeurose do músculo transverso do abdome foi realizada durante exames ultrassonográficos de rotina da parede anterolateral do abdome em 90 indivíduos de ambos os gêneros, maiores de 25 anos e estes dados foram relacionados com 60 dissecções da parede abdominal realizadas em cadáveres não fixados. Resultados: Os exames ultrassonográficos não evidenciaram falhas significativas na aponeurose do músculo transverso do abdome nos 90 indivíduos estudados e a largura das aponeuroses de Spiegel variou de 0,83 a 2,93 cm (média de 1,72 cm). Durante as dissecções do transverso do abdome foram encontradas alterações anatômicas em 14 de 60 músculos e aponeuroses estudadas (23,3%)...

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Spigelian hernia: Rare or obscure?

Cited by 45 publications

References 13 publications

A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery

A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery

Large Spigelian Hernia

Aspectos ultrassonográficos e anatomia da aponeurose do músculo transverso do abdome

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Spigelian hernia: Rare or obscure?

Cited by 45 publications

References 13 publications

A feasibility report of a novel and unpublished surgical approach for Spiegel&#39;s hernia: reconstruction using robotics-assisted surgery

A feasibility report of a novel and unpublished surgical approach for Spiegel&#39;s hernia: reconstruction using robotics-assisted surgery

Large Spigelian Hernia

Aspectos ultrassonográficos e anatomia da aponeurose do músculo transverso do abdome

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A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery

A feasibility report of a novel and unpublished surgical approach for Spiegel's hernia: reconstruction using robotics-assisted surgery