Surgical Repair of Postoperative Perineal Hernia: A Case for the Perineal Approach

Hung, Laurie Y.; Abbass, Mohammad Ali; Sapcı, İpek; Shawki, Sherief; Steele, Scott R.; Görgün, Emre

doi:10.1097/dcr.0000000000002374

Cited by 6 publications

(2 citation statements)

References 19 publications

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“…However, in regard to SPH treatment, there are no valid comparative trials and only case reports or case series are available in the literature. The largest case series study for SPH examined 36 cases, in which only 15 cases were repaired with the same technique [16], and were followed with a median period of 12.7 months. Notwithstanding its limitations, we believe that the present study adds valuable findings, since it presents outcomes of SPH patients operated with the same type of mesh and the same operative approach, and who were followed for the median period of approximately 3 years.…”

Section: Discussionmentioning

confidence: 99%

Transperineal Repair of Secondary Perineal Hernia Using a Mesh with a Memory-recoil Ring

Suwa,

Kurogochi,

Ushigome

et al. 2023

J Anus Rectum Colon

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Objectives: The aim of this study was to evaluate the effectiveness of transperineal repair of secondary perineal hernia (SPH) using a mesh with a memory-recoil ring. Methods: Seven patients with SPH who underwent transperineal repair (TPR) between July 2010 and May 2022 were retrospectively analyzed. TPR was performed using a mesh with a memory-recoil ring. Results: All SPHs developed after abdominoperineal resections in patients with anorectal malignancies. The median longitudinal and transverse diameters of the hernia orifice were 8 (7-10) cm and 6 (5-7) cm, respectively. In all cases, the mesh was fixed to the ischial tuberosity, residual levator muscle, coccygeus muscle, and coccyx after thorough dissection of the sac. The median operation time was 154 (142-280) min. Perioperative complications occurred in 2 cases (29%). One was enterotomy, which caused postoperative mesh infection requiring extraction of the mesh. The other was vaginal injury, which resulted in vaginal fistula but closed spontaneously. The median postoperative length of stay was 9 (5-14) days. No recurrence was observed during a median follow-up of 35 (9-151) months. Conclusions: TPR using a mesh with a memory-recoil ring is safe, feasible and promising technique for SPH repairs.

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Section: Discussionmentioning

confidence: 99%

Transperineal Repair of Secondary Perineal Hernia Using a Mesh with a Memory-recoil Ring

Suwa,

Kurogochi,

Ushigome

et al. 2023

J Anus Rectum Colon

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“…Historically, the cited complication rate for standard APR was 1% [2]; however, with the advent of extralevator APR the rates of perineal hernia have been described as high as 26% [3]. Perineal hernias can be surgically repaired via a perineal or abdominal approach or a combined abdominal and perineal approach [4].…”

mentioning

confidence: 99%

Robotic repair of perineal hernias: a video vignette and review of the literature

et al. 2022

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Background Perineal hernias can be secondarily acquired following abdominoperineal resection of the rectum. While transabdominal minimally invasive techniques have traditionally used laparoscopy, there are few studies published on the robotic platform, which has been gaining popularity for other types of hernia repairs. We review the existing literature, share a video vignette, and provide practical tips for surgeons interested in adopting this approach. Methods A literature search in Pubmed was performed to include all articles in English describing robotic repair of perineal hernias with identification of variables of interest related to repair. A case presentation with an accompanying video vignette and lessons learned from the experience are provided. Results Seven case reports (four containing video) published between 2019 and 2022 were included. Most articles (n = 5) utilized the Da Vinci Si or Xi, and most patients (n = 5) had undergone abdominoperineal resection with neoadjuvant chemotherapy to treat rectal cancer. Patients were positioned in Trendelenburg with rightward tilt (n = 2), modified lithotomy (n = 1), or a combination of the two (n = 1). All articles (n = 7) reported closing the defect and using mesh. Three articles describe placing five ports (one camera, three robotic, one assistant). There were no significant intraoperative or postoperative complications reported, and no recurrence noted at 3–27 months follow-up. Based on our experience, as shown in the video vignette, we recommend lithotomy positioning, using porous polypropylene mesh anchored to the periosteum of the sacrum and peritoneum overlying the bladder and side wall, and placing a drain above the mesh. Conclusions A robotic transabdominal approach to perineal hernia repair is a viable alternate to laparoscopy based on low complication rates and lack of recurrence. Prospective and longer duration data are needed to compare the techniques.

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Robotische Versorgung von perinealen Hernien und Netz-Rekonstruktion des Beckens nach abdominoperinealer Rektumextirpation

Soliman

2024

Roboterassistierte Hernienchirurgie

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Surgical Repair of Postoperative Perineal Hernia: A Case for the Perineal Approach

Cited by 6 publications

References 19 publications

Transperineal Repair of Secondary Perineal Hernia Using a Mesh with a Memory-recoil Ring

Transperineal Repair of Secondary Perineal Hernia Using a Mesh with a Memory-recoil Ring

Robotic repair of perineal hernias: a video vignette and review of the literature

Robotische Versorgung von perinealen Hernien und Netz-Rekonstruktion des Beckens nach abdominoperinealer Rektumextirpation

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