Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review

Abstract

Introduction. Spigelian hernia is a type of lateral ventral hernia, localized between the rectus abdominis muscle and the semilunar line. Current literary data indicate that the prevalence of Spigelian hernia is 1-2% of all hernias of the abdominal wall. Patients are most commonly asymptomatic. Case outline. We present a 63-year-old male patient, who was admitted to our hospital as an emergency case due to lower abdominal pain. Upon hospital admission, radiological diagnostics, and a physical examination, the presence of a Spigelian hernia was verified, which, at the moment of the examination, was incarcerated. It was established that surgical treatment was indicated. We performed laparoscopic intraperitoneal onlay mesh plastic in the standard way. The patient was discharged from hospital on the following day with normal values of vital and laboratory parameters. Conclusion. The Spigelian hernia, although first described many years ago, remains a diagnostic challenge, which is why its occurrence requires a multidisciplinary approach for the purpose of establishing a timely and accurate diagnosis. Within the surgical treatment of this state, there are several surgical techniques, and special focus is placed on the minimally invasive surgical approach. Also, within the minimally invasive surgical approach, there are several operating techniques.