Laparoscopic surgery for treatment of incisional lumbar hernia

Abstract

The surgical correction of incisional lumbar hernia by laparoscopic access is an excellent option for a minimally invasive treatment, with adequate long-term results.

Kugel patch repair of superior lumbar hernias

“…Although more cases have been reported in the literature, because of surgeon's knowledge of lumbar hernia and the introduction of new diagnostic techniques recently, there are still only about 400 cases reported worldwide [6][7][8][9][10][11][12][13][14][15]. Approximately 55 % of lumbar hernias are acquired primarily, 25 % being secondary and the remainder being congenital in origin [6,7,13].…”

“…This technique has reported low morbidity, less significant pain, and earlier returns to normal activities [23][24][25][26][27][28]. Although there was a report of recurrence after laparoscopic repair due to the detachment of a spiral anchor [29], there was also a report of chronic pain because of fixed clamp injuring the nervous bundle at the posterior abdominal wall [14]; until now, however, no large series of serious complications and recurrent rate have been reported. Consequently, there is no sufficient evidence to prove which approach is better.…”

Transperitoneal laparoscopic repair of a dorsal lumbotomy incisional hernia

“…6 Since the first laparoscopic repair in 1996, 7 at least 40 cases of laparoscopic lumbar hernia repair have been reported. [8][9][10][11][12][13] Lumbotomy hernias are often asymptomatic but usually come to medical attention because of pain, bulging over the incision or altered bowel habits. Provocation manoeuvres such as standing or coughing may cause ballooning.…”

“…8,9 Recurrence following repair is possible, although only 1 case has been published. 9 The largest series of lumbotomy hernia repair was reported by Tobias-Machado and colleagues 11 in 2005 in which they describe 7 patients treated successfully with transperitoneal laparosocopic mesh repair. The lumbotomy incision has historically been the classic approach in Brazil for nephrectomy, explaining the authors' relatively large series.…”

Flank hernia and bulging after open nephrectomy: mesh repair by flank or median approach? Report of a novel technique

“…Salameh et al reported in 2004 two cases of flank herniation (one case of a true flank hernia and another one of a flank bulge), which were laparoscopic with a treansabdominal inlay implantation of a PTFE mesh with optimal short-term results [6]. Tobias-Machado et al reported seven cases of a flank hernia repair with a laparoscopic preperitoneal implantation of polypropylene mesh [9]. It is however unknown if this technique enables a complete peritoneal coverage of the mesh.…”