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

Abstract

Laparoscopic TAPP repair of SH without closing the defect is safe, effective, and durable. There is no additional benefit from routine closure of the fascial defect. On the contrary, there may be potential advantages in leaving the defect unopposed.

Spigelian Hernia: Case Series and Review of the Literature

“…This hernia subsequently recurred. IPOM was the most commonly used technique despite the risk of adhesions developing between the peritoneal contents and the mesh [9,18]. The defect was not closed in any study.…”

Spigelian Hernia Containing an Incarcerated Appendix- A Case Report and Literature Review

“…In the cases described in the literature it is less of a common occurrence for the hernia contents to enclose tissues such as the appendix, small intestine, colon, stomach, gall bladder, blind gut, Meckel's diverticulum or ovarium [14][15][16][17]. Due to its location, the appendix is usually a component of abdominal hernias located on the right side of the body [6,[14][15][16][17] as was the case in our patient. According to the literature review there are approximately 10 cases of the appendix incarcerated in SH described to date [2,17].…”

“…Obesity and comorbidities usually do not significantly influence the duration of hospitalization or the result of surgery. In the majority of cases the patients were discharged within one day [1,3,14]. Every case requires surgical treatment which involves either open or laparoscopic approach.…”

“…Untreated it can also lead to obstruction, necrosis and bowel perforation. The risk of recurrence is not very low, and it ranges from 5% to 14% [1,3,[5][6][7]14,15,19].…”

“…Open surgery should be performed in the severe cases and if the laparoscopic method is not available. The experience of a surgeon must also be taken into consideration [1,2,4,7,8,14,15].…”