Spigelian hernias: a prospective analysis of baseline parameters and surgical outcome of 34 consecutive patients

Malazgirt, Zafer; Topgül, Koray; Sökmen, Selman; Ersin, Sinan; Türkçapar, Ahmet Gökhan; Gök, Hakan; Gönüllü, Neşet Nuri; Paksoy, Melih; Ertem, Metin

doi:10.1007/s10029-006-0103-5

Cited by 37 publications

(33 citation statements)

References 25 publications

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“…Spigelian hernias are difficult to diagnose unless causing symptoms. The incidence of Spigelian hernia is unknown, but seems to be higher in the fourth to seventh decade of life, including more women than men, and more left‐sided than right‐sided.…”

Section: Resultsmentioning

confidence: 99%

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

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Background Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. Methods The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full‐text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. Results Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. Conclusion This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.

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Section: Resultsmentioning

confidence: 99%

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Barnes

McFaul²,

Abdelrazeq³

2014

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…However, the optimal surgical approach is still controversial. Although open hernioplasty with the use of polypropylene mesh constitutes the most frequent technique, laparoscopic approaches has been increasingly used in recent years (8). Laparoscopic treatment modalities can be transperitoneal so called intraabdominal and extraperitoneal.…”

Section: Discussionmentioning

confidence: 99%

A rare case of Spigelian hernia combined with direct and indirect inguinal hernias

2017

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Spigelian hernia is a rare type of ventral hernias with nonspecific symptoms and signs. Therefore, its diagnosis is often difficult and requires more clinical attention. Although intermittent abdominal swelling and pain are the main symptoms, Spigelian hernias can be sometimes asymptomatic and are discovered incidentally at the operation. In some cases, these hernias can be associated with other abdominal wall hernias, therefore a detailed physical examination of the patients is necessary to avoid mistakes in diagnosis. Herein, we report an interesting and educational case of Spigelian hernia with accompanying ipsilateral both direct and indirect inguinal hernias in a male patient treated by open surgical repair with use of polypropylene mesh. Keywords:Abdominal wall hernia, inguinal hernia, Spigelian hernia, ventral hernia INTRODUCTIONInguinal hernia is one of the most common surgical disorders in general surgery practice. Indirect form of inguinal hernia is characterized by the presence of a protruding peritoneal sac through the deep inguinal ring. However, Spigelian hernia (SH) is an uncommon type of hernia with an incidence of 0.1-2% of all abdominal wall hernias (1). SH, also known as hernia of semilunar line, is the protrusion of preperitoneal fat, peritoneal sac or intraabdominal organs through a congenital or acquired defect in the Spigelian zone. This zone is formed by the fusion of transverse abdominis and internal oblique aponeurosis, and is bounded medially by the lateral margin of the rectus muscle and laterally by the linea semilunaris. Although the Spigelian aponeurosis extends from the pubic tubercle to the costal cartilage of the eighth rib, most of SHs are located in a 6 cm wide region inferior to the umbilicus and superior to the interspinous line, which is called as the Spigelian hernia belt (Figure 1). However, low SH is rare and may mimic inguinal hernias. Additionally, coexistence of Spigelian and inguinal hernia is an extremely rare clinical entity. To our knowledge, there is a small number of cases of SH combined with inguinal hernia in the literature. Herein, we report a case of low SH with incidentally found coexisting ipsilateral inguinal hernia in a 62 years-old male patient. CASE PRESENTATIONA 62-years-old-man presented with a painful abdominal swelling at the right lower quadrant of abdomen for approximately 3 years. He was retired with a medical past of umbilical hernia repair and laparoscopic cholecystectomy before 10 and 6 years, respectively, and diabetes mellitus under treatment. Abdominal examination revealed the presence of a painful, reducible bulge located between the umbilicus and right anterior superior iliac spine (Figure 2). The mass was more prominent while the patient was standing and coughing. Ultrasound (US) revealed a fascial defect, 18 mm in diameter, at the lateral border of the rectus muscle in the right lower quadrant with herniation of bowel loops. The hernia sac was revealed by transverse skin incision, and it was seen that there was not any sign of incarcer...

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Spigelian hernias: a prospective analysis of baseline parameters and surgical outcome of 34 consecutive patients

Cited by 37 publications

References 25 publications

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

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

A rare case of Spigelian hernia combined with direct and indirect inguinal hernias

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