1
|
Kavya SS, Shaikh FA, Shaikh H, Mushahid H, Sydhom M, Nadeem A. Giant spigelian hernia in a middle-aged female: The importance of intraoperative ultrasonography for hernia localization-Case report. SAGE Open Med Case Rep 2024; 12:2050313X241249099. [PMID: 38665933 PMCID: PMC11044791 DOI: 10.1177/2050313x241249099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Spigelian hernia is a rare type of abdominal wall hernia that accounts for only 0.12% of all abdominal hernias. A Spigelian hernia, also known as a spontaneous lateral ventral hernia or a hernia of the semilunar line, occurs when a part of the abdominal contents protrudes through the Spigelian fascia. Due to its anatomical location, Spigelian hernia can be difficult to diagnose through physical examination alone. Here we report a case of a 40-year-old female who experienced right abdominal pain and swelling, where ultrasonography imaging was crucial in the intraoperative diagnosis of Spigelian hernia. The patient underwent laparotomy mesh repair to address the condition. The lack of consistent physical findings and the rarity of the disease require a high level of clinical suspicion in the diagnosis of a Spigelian hernia. Its associated abdominal complaints are often vague and nonspecific, making it even more challenging. This case emphasizes the importance of utilizing imaging techniques to aid in the diagnosis of a Spigelian hernia and prompt surgical intervention to prevent complications associated with the hernia.
Collapse
Affiliation(s)
- Sanka Sai Kavya
- Department of General Surgery, SVS Medical College, Yenugonda, India
| | | | - Humaira Shaikh
- Shadan Institute of Medical Sciences and Research, Peeramchuru, Telangana, India
| | - Hasan Mushahid
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mark Sydhom
- Department of Medicine, Ain Shams University, Cairo, Egypt
| | - Abdullah Nadeem
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
2
|
Cui TYS, Law TT, Ng L, Wong KY. Spigelian hernia: Our total extraperitoneal approach and a systematic review of the literature. Asian J Endosc Surg 2021; 14:529-539. [PMID: 33393194 DOI: 10.1111/ases.12912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 12/07/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Spigelian hernia is a rare lateral ventral hernia traditionally repaired through open incision with extensive dissection. Three laparoscopic techniques have been reported in the literature: intraperitoneal onlay mesh (IPOM), transabdominal preperitoneal (TAPP), and total extraperitoneal (TEP). TEP is less popular than the other approaches. We evaluated TEP's safety and effectiveness and compared different laparoscopic techniques. METHODS All patients with Spigelian hernia who had undergone extended TEP (eTEP) repair with mesh in our center from January 2007 to February 2020 were studied. A three-port technique with a preperitoneal space created by telescope at the midline was adopted. A systematic review on laparoscopic mesh repair was performed by searching for "Spigelian hernia" and "laparoscopic" from 1999 to 2019 in the MEDLINE database. RESULTS Seven patients underwent eTEP repair for Spigelian hernia. Five presented with abdominal mass and underwent preoperative imaging. Two were diagnosed incidentally during TEP for inguinal hernia. The mean operative duration was 65 minutes (range, 40-93 minutes). There were no open conversions or intraoperative complications. The mean length of hospital stay was 1.4 days (range, 1-3 days). The mean follow-up period was 44.3 months. One patient developed seroma. There was no recurrence or chronic pain. We identified 197 laparoscopic mesh repairs reported in 41 articles. IPOM (n = 91) was the most popular approach, followed by TAPP (n = 70) and TEP (n = 36). Laparoscopic mesh repair of Spigelian hernia is safe and offers excellent outcomes. CONCLUSION We found the eTEP approach safe and effective for Spigelian hernia repair. IPOM, TAPP, and TEP are comparable.
Collapse
Affiliation(s)
| | - Tsz Ting Law
- Department of Surgery, Tung Wah Hospital, Hong Kong
| | - Lily Ng
- Department of Surgery, Tung Wah Hospital, Hong Kong
| | | |
Collapse
|
3
|
Valenzuela Alpuche H. Laparoscopic transabdominal preperitoneal repair in the management of Spiegelian hernia – A three-patient case series and review of the literature. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2021. [DOI: 10.4103/ijawhs.ijawhs_29_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Tom SK, Tom TN. Laparoscopic Repair of Right Spigelian Hernia and Umbilical Hernia. Am Surg 2019. [DOI: 10.1177/000313481908500514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Stephanie K. Tom
- University of Louisville School of Medicine Louisville, Kentucky
| | - Todd N. Tom
- Department of General Surgery Tug Valley ARH Medical Center South Williamson, Kentucky
| |
Collapse
|
5
|
Kwok AMF, Sarofim M, Still AB. Terminal ileum within a Spigelian hernia: a rare presentation of small bowel obstruction. ANZ J Surg 2019; 89:E564-E565. [PMID: 30690818 DOI: 10.1111/ans.14976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 10/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Allan M F Kwok
- Department of Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Mina Sarofim
- Department of Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Andrew B Still
- Department of Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia
| |
Collapse
|
6
|
Ye Z, Wang MJ, Bai LF, Zhuang HX, Zhuang W. Spigelian hernia in the right upper abdominal wall: a case report. BMC Surg 2018; 18:109. [PMID: 30482184 PMCID: PMC6260715 DOI: 10.1186/s12893-018-0449-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 11/16/2018] [Indexed: 02/05/2023] Open
Abstract
Background Spigelian hernia (SH) is rare and constitutes less than 2% of all hernias. It is reported that more than 90% of SHs lie in the “Spigelian belt”, but SH in the upper abdominal wall is extremely uncommon. Here, we report a case of SH in the right upper quadrant of abdomen. Case presentation A 38-year-old female was admitted to hospital with complaints of abdominal pain and right upper quadrant mass for 10 days. Contrast-enhanced computed tomography (CECT) of abdomen revealed the dilated small intestine between the swelling ventral muscles in the right upper abdominal wall which suggested a ventral hernia. The surgeons considered it was a spontaneous hernia because there was no history of surgery or trauma in the upper abdomen. About two hours later, the patient underwent emergency surgery. According to laparotomy, a diagnosis of SH with ileum herniation in the right upper abdominal wall was confirmed. The necrotic ileum segment was resected. Meanwhile the abdominal wall defect was repaired by suturing the internal oblique and transverse muscles to the rectus sheath. The patient had a favorable outcome for 1 year without recurrence. Conclusion A mass and pain in the upper abdominal wall may suggest an atypical SH. SH occurring in the upper abdominal wall is a rare condition with possibility of dire outcome if not managed early. Electronic supplementary material The online version of this article (10.1186/s12893-018-0449-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Zhou Ye
- Department of Digestive Diseases, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Mo-Jin Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Li-Fen Bai
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Han-Xiang Zhuang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Wen Zhuang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.
| |
Collapse
|
7
|
Sengar M, Mohta A, Neogi S, Gupta A, Viswanathan V. Spigelian hernia in children: low versus classical. J Pediatr Surg 2018; 53:2346-2348. [PMID: 30017065 DOI: 10.1016/j.jpedsurg.2018.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/24/2018] [Accepted: 06/13/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE Pediatric spigelian hernias are very rare. They are often missed or misdiagnosed. A series of cases with spigelian hernia, presented to a tertiary care center are presented here with emphasis on different anatomy of spigelian hernias with cryptorchidism and those without associated cryptorchidism. MATERIALS AND METHODS Over a period of seven years, nine cases of spigelian hernia presented to our tertiary care center. Male:female ratio was 3:1.There was a preponderance of right sided hernias. Three patients had associated cryptorchidism. One patient had associated lumbar hernia. All three patients with cryptorchidism had low spigelian hernia while others had classical spigelian hernia. CONCLUSION There is a likelihood of anatomical variation in SH associated with UDT and those without UDT. Understanding this anatomy may help in correct scrotal placement of testis. TYPE OF STUDY Prospective Observational. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- Mamta Sengar
- Department of Pediatric Surgery, Chacha Nehru BalChikitsalaya, Geeta Colony, Delhi 110031, India.
| | - Anup Mohta
- Department of Pediatric Surgery, Chacha Nehru BalChikitsalaya, Geeta Colony, Delhi 110031, India
| | - Sujoy Neogi
- Department of Pediatric Surgery, Maulana Azad Medical College, Delhi 110031, India
| | - Alisha Gupta
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi 110031, India
| | - Vivek Viswanathan
- Department of Pediatric Surgery, Chacha Nehru BalChikitsalaya, Geeta Colony, Delhi 110031, India
| |
Collapse
|
8
|
Robotic repair of symptomatic Spigelian hernias: a series of three cases and surgical technique review. J Robot Surg 2017; 12:557-560. [DOI: 10.1007/s11701-017-0742-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
|
9
|
Ussia A, Imperato F, Schindler L, Wattiez A, Koninckx PR. Spigelian hernia in gynaecology. GYNECOLOGICAL SURGERY 2017; 14:8. [PMID: 28603476 PMCID: PMC5440533 DOI: 10.1186/s10397-017-1010-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/05/2017] [Indexed: 11/10/2022]
Abstract
Background A Spigelian hernia is a rare hernia through the Spigelian fascia between the rectus muscle and the semilunar line. This hernia is well known in surgery. Symptoms vary from insidious to localised pain, an intermittent mass and/or a bowel obstruction. Results The Spigelian hernia is poorly known in gynaecology. Spigelian hernias may be causally related to secondary trocar insertion. This review is written to increase awareness in gynaecology and is illustrated by a case report in which the diagnosis was missed for 4 years even by laparoscopy. Smaller hernias risk not to be diagnosed and will thus not be treated. Even larger Spigelian hernias might not be recognised and treated appropriately. Conclusions The gynaecologist should consider a Spigelian hernia in women with localised pain in the abdominal wall lateral of the rectus muscle some 5 cm below the umbilicus. Smaller hernias can be closed by laparoscopy without a mesh. Larger hernias require a mesh repair.
Collapse
Affiliation(s)
- Anastasia Ussia
- Villa Del Rosario, Rome, Italy.,Gemelli Hospitals, Università Cattolica, Rome, Italy
| | | | | | | | - Philippe R Koninckx
- Department of Obstetrics and Gynecology, Catholic University Leuven, University Hospital, Gasthuisberg, B-3000 Leuven, Belgium. Vuilenbos 2 3360, Bierbeek, Belgium
| |
Collapse
|
10
|
Abstract
PURPOSE Spigelian hernias (SHs) account for 1% to 2% of abdominal wall hernias. Traditionally they have been repaired using an open technique. Since 1992, laparoscopic methods have become increasingly popular with various techniques being described in the literature. This systematic review aims to represent the current trends in laparoscopic repair of SHs. MATERIALS AND METHODS The databases MEDLINE and EMBASE were searched for appropriate terms regarding SH repair. Papers describing laparoscopic repair of SH were included. RESULTS Fifty articles were identified for the final review. No randomized controlled trials comparing laparoscopic techniques were identified. Two hundred thirty-seven SHs were repaired by various techniques. Intraperitoneal onlay mesh technique was the most popular repair method with minimal complications and recurrences reported in all techniques. CONCLUSIONS There are a number of laparoscopic techniques available to the surgeon repairing a SH. Overall, laparoscopic repair of the SH is a safe and acceptable method.
Collapse
|
11
|
Webber V, Low C, Skipworth RJE, Kumar S, de Beaux AC, Tulloh B. Contemporary thoughts on the management of Spigelian hernia. Hernia 2017; 21:355-361. [PMID: 28097450 DOI: 10.1007/s10029-017-1579-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/06/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spigelian hernias are said to be a rare condition of the elderly population, usually arising below the arcuate line. Local experience has led us to challenge these commonly held beliefs. METHODS Operations for Spigelian hernia from 2006-2016 were identified from the Edinburgh Lothian Surgical Audit computerised database and case notes were reviewed. RESULTS One hundred and one patients underwent surgery for 107 Spigelian hernias in the 10-year period. The female-to-male ratio was 2:1. Ages ranged from 32 to 88 with a median of 64 years. Sixty-five operations were done open and 42 were laparoscopic. Twelve of the 27 for which the precise anatomic location was recorded were situated above the arcuate line. Twenty-nine hernias had small defects and comprised interstitial fat only with no peritoneal sac. Ages in this group ranged from 32 to 80 (median = 48 years). All presented with intermittent local pain and/or swelling, although in three patients the hernias were impalpable. Those three also underwent ultrasound, CT and/or laparoscopy, but the hernias were only identified after open surgical exploration. The remaining 78 cases had peritoneal sacs of varying size with defects up to 9 cm across, and all were identified on imaging and/or laparoscopy. Ages ranged from 38 to 88 (median = 67 years; p < 0.01). Eighteen patients presented as emergencies and all were in this group. CONCLUSION Spigelian hernias may be more common than we think and are probably under-diagnosed. They commonly arise above the arcuate line. We describe three clinical stages: Stage 1 hernias are those without peritoneal sacs and tend to arise in younger patients, can be difficult to diagnose and may not seen at laparoscopy. Stages 2 and 3 hernias arise in older patients, do have peritoneal sacs, are visible at laparoscopy and are more likely to present as emergencies. Stage three hernias are too large for laparoscopic repair. The differences between stages likely reflect the natural history of the condition, which begins as extraperitoneal fat protrusion and progresses over many years to develop a peritoneal sac.
Collapse
Affiliation(s)
- V Webber
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK
| | - C Low
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK
| | - R J E Skipworth
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK
| | - S Kumar
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK
| | - A C de Beaux
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK
| | - B Tulloh
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK.
| |
Collapse
|
12
|
Moreno-Egea A, Campillo-Soto Á, Morales-Cuenca G. Which should be the gold standard laparoscopic technique for handling Spigelian hernias? Surg Endosc 2014; 29:856-62. [PMID: 25060686 DOI: 10.1007/s00464-014-3738-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 07/08/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The advantages and disadvantages of both extraperitoneal and intra-abdominal laparoscopic Spigelian hernia repair are still being discussed. To our knowledge, no study has compared both techniques in terms of safety, feasibility, and cost-effectiveness. METHOD Prospective data were collected to compare the results of the extraperitoneal approach with the intra-abdominal approach in laparoscopic Spigelian hernia repair, between 2000 and 2012 (n = 16). Diagnosis was confirmed preoperatively by ultrasonography and/or tomography. RESULTS Spigelian hernias occur mostly in women (69 %), on the left side (56 %) and at a median age of 62 (range: 38-83). In our study, the extraperitoneal technique was performed in seven patients, while the intra-abdominal approach was indicated in nine. No complications, re-admissions, or recurrences were detected in either during a mean follow-up of 48 months (range: 18 months-9 years). The statistical study showed that there was no difference in either morbidity or the recurrence rate between a totally extraperitoneal (TEP) and an intraperitoneal onlay mesh (IPOM) repair. The mean duration of an IPOM repair was, though, shorter than that of a TEP repair (30 vs. 48 min, P = 0.06). The combined fixation technique (tacks + glue) did not modify the results but did reduce the costs, as shown in the cost-effectiveness study where the intra-abdominal approach was cheaper (1260 vs. 2200 euros, P < 0.001). CONCLUSION Laparoscopy seems to be a safe and feasible technique whichever the approach chosen, be it intra or extraperitoneal. Our experience shows that intra-abdominal laparoscopic Spigelian hernia repair should be recommended as the gold standard because of its technical and economic advantages. The IPOM procedure with a lightweight titanium-coated mesh fixed using a combined technique is a highly effective option for Spigelian hernia repair.
Collapse
Affiliation(s)
- Alfredo Moreno-Egea
- Abdominal Wall Unit, Department of Surgery, Morales Meseguer University Hospital, Avda Primo de Rivera 7, 5ºD, 3008, Murcia, Spain,
| | | | | |
Collapse
|
13
|
Ghosh SK, Sharma S, Biswas S, Chakraborty S. Adriaan van den Spiegel (1578-1625): Anatomist, physician, and botanist. Clin Anat 2014; 27:952-7. [PMID: 24811238 DOI: 10.1002/ca.22414] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/21/2014] [Accepted: 04/23/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy; ESI-PGIMSR & ESIC Medical College; Joka Kolkata West Bengal India
| | - Suranjali Sharma
- Department of Anatomy; ESI-PGIMSR & ESIC Medical College; Joka Kolkata West Bengal India
| | - Sudipa Biswas
- Department of Anatomy; ESI-PGIMSR & ESIC Medical College; Joka Kolkata West Bengal India
| | - Soumya Chakraborty
- Department of Anatomy; ESI-PGIMSR & ESIC Medical College; Joka Kolkata West Bengal India
| |
Collapse
|
14
|
Kanhere H, Bruening M. Bilateral spigelian hernias: diagnosis and treatment in a regional hospital. Aust J Rural Health 2014; 22:45-6. [PMID: 24461000 DOI: 10.1111/ajr.12073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Harsh Kanhere
- The Department of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | | |
Collapse
|
15
|
Noomene R, Bouhafa A, Maamer AB, Haoues N, Oueslati A, Cherif A. [Spigelian hernias]. Presse Med 2014; 43:247-51. [PMID: 24439537 DOI: 10.1016/j.lpm.2013.06.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 06/18/2013] [Indexed: 11/18/2022] Open
Abstract
Spigelian hernias represent 1-2% of all abdominal wall hernias. The pathogenesis often involves a dehiscence of the transverse and internal oblique muscle aponeurosis. The diagnosis is made by physical examination; but sometimes it is complicated by obesity. The risk of strangulation is important and can reach 30%. The abdominal CT scan is helpful in the description of hernia's topography and sometimes in diagnostic confirmation. The treatment is surgical. The rate of recurrence after direct closure is considerable. Synthetic mesh repair seems to be a more adequate alternative. The advent of laparoscopy has improved the management of these hernias.
Collapse
Affiliation(s)
- Rabii Noomene
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie.
| | - Ahmed Bouhafa
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | - Anis Ben Maamer
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | - Noomen Haoues
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | | | - Abderraouf Cherif
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| |
Collapse
|
16
|
Spigelian hernia repair as a day-case procedure. Hernia 2012; 17:483-6. [PMID: 23076625 DOI: 10.1007/s10029-012-1002-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 09/30/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Only a few series of patients with a spigelian hernia managed on an outpatient basis have been reported in the literature. The aim of this prospective study was to evaluate the results of the elective spigelian hernia repair as an ambulatory procedure. METHODS From June 2007 to June 2010, 8 patients with 9 spigelian hernias were electively operated on under local anesthesia as a day case. Four patients had unilateral spigelian hernia, 1 had spigelian and inguinal on the same side, 1 had spigelian and epigastric, 1 had spigelian and umbilical, and 1 patient had bilateral spigelian and umbilical hernia. Spigelian hernia was managed by the "open preperitoneal flat mesh technique." In patients with several ventral hernias at different sites, "the open preperitoneal flat mesh technique" was performed using one separate flat mesh for each of the hernias; for the patient with inguinal hernia, the Lichtenstein procedure was performed in addition. RESULTS No complications and recurrences were recorded during a mean follow-up of 23.5 months (range: 11-35). CONCLUSION The elective spigelian hernia can be successfully repaired under local anesthesia as a day-case procedure. The "open preperitoneal flat mesh technique" provides excellent results under these conditions.
Collapse
|
17
|
Iqbal CW, St Peter SD, Hendrickson RJ. Repair of a traumatic lateral abdominal wall hernia in an 11-year-old boy, using a minimally invasive approach. TRAUMA-ENGLAND 2012. [DOI: 10.1177/1460408612440926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We present the case of an 11-year-old boy who sustained blunt abdominal trauma while bicycling. An abdominal computed tomography scan obtained during his trauma evaluation was suspicious of a right-sided abdominal wall hernia with acute inflammatory changes although there was no palpable mass on physical examination. In follow-up, he was found to have a palpable mass in his right lateral abdominal wall, which enlarged with valsalva. The hernia was repaired primarily using a minimally invasive approach with a 5-mm umbilical cannula and a stab incision over the defect. He was discharged home on the first post-operative day. At 1 year follow-up, he is symptom-free without evidence of recurrence. Lateral abdominal wall hernias in the pediatric patient are uncommon but can result from trauma. Primary repair using a minimally invasive approach is safe and effective in achieving adequate closure.
Collapse
Affiliation(s)
- Corey W Iqbal
- Children’s Mercy Hospital and Clinics, Kansas City, MO, USA
| | | | | |
Collapse
|
18
|
Perrakis A, Velimezis G, Kapogiannatos G, Koronakis D, Perrakis E. Spigel hernia: a single center experience in a rare hernia entity. Hernia 2012; 16:439-44. [DOI: 10.1007/s10029-012-0925-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 05/11/2012] [Indexed: 11/29/2022]
|
19
|
|
20
|
Lopez R, King S, Maoate K, Beasley S. Laparoscopic repair of paediatric traumatic Spigelian hernia avoids the need for mesh. ANZ J Surg 2011; 81:396-7. [PMID: 21518204 DOI: 10.1111/j.1445-2197.2011.05720.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
21
|
[Combined endoscopic treatment of Spigelian hernia : laparoscopy - total extraperitoneal patch plasty - laparoscopy]. Chirurg 2011; 82:932, 934-5. [PMID: 21695556 DOI: 10.1007/s00104-011-2133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Spigelian hernias are rare forms of abdominal hernia but can lead to severe complications. Besides conventional techniques there are only a few reports on the successful use of minimally invasive surgery (MIS) techniques. In this paper the combination of laparoscopy and TEP (total extraperitoneal patch plasty) technique without mesh fixation is presented. In our opinion laparoscopy - TEP - laparoscopy is a logical, safe and beneficial method for treatment of Spigelian hernias.
Collapse
|
22
|
Patle NM, Tantia O, Sasmal PK, Khanna S, Sen B. Laparoscopic Repair of Spigelian Hernia: Our Experience. J Laparoendosc Adv Surg Tech A 2010; 20:129-33. [DOI: 10.1089/lap.2009.0314] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Nirmal M. Patle
- Department of Minimal Access Surgery, ILS Hospital, Kolkata, India
| | - Om Tantia
- Department of Minimal Access Surgery, ILS Hospital, Kolkata, India
| | | | - Shashi Khanna
- Department of Minimal Access Surgery, ILS Hospital, Kolkata, India
| | - Bimalendu Sen
- Department of Minimal Access Surgery, ILS Hospital, Kolkata, India
| |
Collapse
|
23
|
|