Low Spigelian Hernias: Experience of 26 Consecutive Cases in 24 Patients

Klimopoulos, Serafim; Kounoudes, Christos; Validakis, Anastasios; Galanis, G.D.

doi:10.1080/110241501753171272

Cited by 9 publications

(5 citation statements)

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“…This technique has been proposed to distinguish between these two hernias, but can be uncomfortable and even painful for the patient. The diagnosis can be confirmed by radiological investigation and final assessment is best done intraoperatively [56]. Although, very rare, if both the hernias are found it is most likely due to weakness of Spigelian fascia around the insertion of rectus abdominis [45].…”

Section: Low Spigelian Herniasmentioning

confidence: 99%

Spigelian Hernia: Clinical Features and Management

Goswami¹,

Huda²,

Singh³

et al. 2022

Hernia Surgery

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The Spigelian hernia is a rare variety of ventral hernia and has an incidence ranging from 0.1–2% of all abdominal wall hernias. It occurs through a well-defined defect in the Spiegel’s fascia adjacent to the semilunar line. It can be congenital or acquired. The acquired variety is predisposed by stretching and weakening of the abdominal wall by factors that increase the intraabdominal pressure. These hernias are most commonly located in the interparietal plane with no visible or palpable mass, and only 50% of cases could be diagnosed clinically before any surgical intervention. Radiological investigations like USG and CT scans confirm the clinical diagnosis or pick up the subclinical varieties that present with non-specific pain in the anterior abdominal wall. Surgery is the mainstay of management. These hernias are prone to early incarceration and strangulation and therefore should be operated at the earliest. It is stressed that a prosthetic mesh should be used for a better outcome as it decreases recurrence. Conventional open hernioplasty has been largely replaced by a laparoscopic approach such as TAPP, TEP, IPOM and robotic-assisted surgery. Early diagnosis and surgery prevent morbidity and dreaded complications.

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Section: Low Spigelian Herniasmentioning

confidence: 99%

Spigelian Hernia: Clinical Features and Management

Goswami¹,

Huda²,

Singh³

et al. 2022

Hernia Surgery

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“…In a recent series, Spigelian hernias located cranially to the arcuate line were reported in more than 10% of patients [5]. Furthermore, the term "Low Spigelian hernia" qualifies a SpH subtype located caudally to the inferior epigastric artery, within the Hesselbach's triangle, first introduced by Spangen [4], and found in about 8% of groin hernia repairs in the Klimopoulos series [6].…”

Section: Surgical Anatomymentioning

confidence: 99%

Section: Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

“…Low SpH can be mistaken with inguinal hernia, and final diagnosis is only confirmed intraoperatively [5,6]. A digital palpation of the patient's inguinal canal with Valsalva manoeuvre in a standing position has been proposed to distinguish between low SpH and direct inguinal hernia [6]. Co-existence of low SpH and direct inguinal hernia has been reported, most likely due to concomitant weakness of the Spigelian fascia around insertion of the rectus abdominis [19].…”

Section: Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

“…A distinction between SpH with and without peritoneal components was recently described, which has an impact on the choice of the appropriate surgical approach [5]. Low SpH can be classified in the Nyhus (type Ib) or Gilbert (type 5) inguinal hernia classifications [6].…”

Section: Classificationmentioning

confidence: 99%

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Spigelian hernia: current approaches to surgical treatment—a review

Hanzalova

Schäfer

Demartines

et al. 2021

Hernia

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Background Spigelian hernias (SpH) belong to the group of eponymous abdominal wall hernias. Major reasons for diagnostic difficulties are its low incidence reaching maximum 2% of abdominal wall hernias, a specific anatomical localization with intact external oblique aponeurosis covering the hernia sac and non-constant clinical presentation. Methods A literature review was completed to summarize current knowledge on surgical treatment options and results. Results SpH presents a high incarceration risk and therefore should be operated upon even if the patient is asymptomatic. Both laparoscopic and open repair approaches are validated by current guidelines with lesser postoperative complications and shorter hospital stay in favour of minimally invasive surgery, regardless of the technique used. Overall recurrence rate is very low. Conclusion All diagnosed SpH should be planned for elective operation to prevent strangulated hernia and, therefore emergency surgery. Both open and laparoscopic SpH treatment can be safely performed, depending on surgeon’s experience. In most cases, a mesh repair is generally advised.

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Spigelian Hernias: Diagnosis and Treatment

Miserez¹,

Schreinemacher

2012

The SAGES Manual of Hernia Repair

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Low Spigelian Hernias: Experience of 26 Consecutive Cases in 24 Patients

Cited by 9 publications

References 0 publications

Spigelian Hernia: Clinical Features and Management

Spigelian Hernia: Clinical Features and Management

Spigelian hernia: current approaches to surgical treatment—a review

Spigelian Hernias: Diagnosis and Treatment

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