Emergency Intraperitoneal Onlay Mesh Repair of Incarcerated Spigelian Hernia

Abstract

This report suggests that Spigelian hernia in an emergency setting may be easily and quickly repaired with an intraperitoneal onlay method using composite mesh.

Incarcerated Spigelian Hernias: A Rare Cause of a High-grade Small Bowel Obstruction

“…It is rare for patients to present with obstructive symptoms. In two large series studies (n < 100), the incidence of incarcerated Spigelian hernia was 17% and 33%, respectively [4]. Most reported incidences were only from small case reports.…”

Laparoscopic Transabdominal Preperitoneal Repair of Spigelian Hernia—Closure of the Fascial Defect Is Not Necessary

“…49,50 The most commonly reported (39%) laparoscopic method of SH repair is the intraperitoneal onlay mesh technique. 12,13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] This procedure involves reduction of the hernial contents and placement of a composite mesh directly on the abdominal wall. Although the technique is relatively simple, its major drawbacks are the possibility of interactions between peritoneal contents and the mesh potentially causing significant complications.…”

“…Of the laparoscopic SH repairs reported in the literature, the most popular repair is the intraperitoneal onlay mesh method, followed by transabdominal preperitoneal (TAPP) repair. 12,13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] The majority of surgeons reporting use of the TAPP repair close the defect despite there being no evidence in the literature supporting this. 16,19,31,[34][35][36] Here we report the outcome of the largest series of patients undergoing laparoscopic TAPP repair of SH that deliberately omits approximation of the fascial defect.…”

Emergent Laparoscopic Repair of a Spigelian Hernia: Case Report and Review of the Literature

“…We were only able to retrieve eight case reports that have discussed the laparoscopic repair of a spigelian hernia in an emergent setting [1, 4–10, 18]. Surgical techniques are variable throughout the eight cases, but, in each case, the surgeons decided to close the defect with mesh attached by staples, sutures and/or tacks.…”