Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia: A case report

BackgroundA 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.ResultsThe 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.ConclusionsThe 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.

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“…Also during these repairs, laparoscopy is a useful aid as discussed in two recent case reports [29, 30]. …”

Section: Resultsmentioning

confidence: 99%

“…An extra peritoneal mesh repair remains the gold standard [ 16 ]. Also during these repairs, laparoscopy is a useful aid as discussed in two recent case reports [ 29 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

Spigelian hernia in gynaecology

Ussia¹,

Imperato²,

Schindler

et al. 2017

Gynecol Surg

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“…However, there is a risk of intestinal adhesion or fistula, and it can be life-threatening (19). TEP technique is already used in laparoscopic repair of many types of hernia, with good results (11,(20)(21)(22). We successfully separated the peritoneum by TEP endoscopy and repaired the parastomal hernia using synthetic mesh (without anti-adhesion coating).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Totally Extraperitoneal Repair of Parastomal Hernia: A Case Report

Jiang¹,

Thapa

Ma³

et al. 2021

Front. Surg.

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A parastomal hernia is a type of incisional hernia that occurs in abdominal integuments in the proximity of a stoma. It is a frequent late complication following colostomy. Surgical repair is currently the only treatment option for parastomal hernia. Here we present the case of a 74-year-old patient with parastomal hernia and a history of open surgery treated with a totally extraperitoneal (TEP) endoscopic approach. There was no recurrence of the hernia at the 3-month follow-up. We discuss the feasibility and possible operative approaches for endoscopic repair of parastomal hernia with the TEP technique.

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“…More than 90% occur in the Spigelian hernia belt. This belt is a six centimeter wide area transversely located superior to the interspinal plane and inferior to umbilicus [ 3 , 4 ]. Their aetiology remains nebulous due to the rarity of the condition.…”

Section: Discussionmentioning

confidence: 99%