Which should be the gold standard laparoscopic technique for handling Spigelian hernias?

Moreno-Egea, Alfredo; Campillo-Soto, Álvaro; Morales-Cuenca, Germán

doi:10.1007/s00464-014-3738-9

Cited by 41 publications

(53 citation statements)

References 21 publications

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“…Surgery is indicated with SH due to the fibrous bands of Spigelian fascia forming a rigid neck making incarceration and strangulation a risk. The incidence of incarceration has been reported to be around 24-27% [5,9] and that of strangulation between 2 and 14% [10]. SH may consist of preperitoneal fat only but may also contain small bowel, colon, or omentum.…”

Section: Discussionmentioning

confidence: 99%

Spigelian Hernia: Case Series and Review of the Literature

Rankin

Kostusiak

Sokker³

2018

Visc Med

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Background: Spigelian hernia (SH) is an uncommon ventral abdominal hernia. Traditionally repaired with an open technique, the laparoscopic approach is becoming more common and widely described in the literature. We hold that the transabdominal preperitoneal (TAPP) approach restores the anatomy and prevents complications such as seroma. We present a series of SH repair carried out at a single district general hospital over the past 13 years and a review of the literature. Methods: A retrospective case note review identified SH repaired between January 2005 and March 2018 at The Queen Elizabeth Hospital, King's Lynn, Norfolk, UK. A Medline search for ‘Spigelian hernia' and ‘laparoscopic' revealed 41 papers for review. Results: 33 patients underwent repair of SH. We found that the TAPP repair with a mesh is anatomically the most sound repair, with all the added benefits of keyhole surgery, i.e. reduced hospital stay, quicker recovery, and fewer infections. Our complication rates matched those described in the literature. Conclusions: Several operative techniques have been described to repair SH. We favour the laparoscopic TAPP approach which is safe, aids in confirming the correct diagnosis, and has all the benefits of keyhole surgery.

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Section: Discussionmentioning

confidence: 99%

Spigelian Hernia: Case Series and Review of the Literature

Rankin

Kostusiak

Sokker³

2018

Visc Med

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“…Laparoscopic treatment modalities can be transperitoneal so called intraabdominal and extraperitoneal. The violation of peritoneal layer seems to be the main advantage of TEP approach, but intraabdominal SH repair was recommended as a gold standart technique due to its technical and economic advantages in a recent study (9). Independent of laparoscopic operation type, less postoperative infectious complications, less recurrence rate, less postoperative pain, less hospital stay, and early resumption of daily activities are the main advantages of laparoscopic techniques (10).…”

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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“…In 1746, Beatricio La Chausse isolated a hernia in this region [2]. The term "Spigelian hernia" was first coined by Josef Klinkosch in 1764 [2,[4][5][6]. Currently, this name refers to a hernia whose gate is located within the fascia of the transverse abdominal muscle that is limited laterally by the semilunar line [1,2,[4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly accompanying comorbidities include: diabetes, peripheral vascular disease, cerebrovascular disease, COPD, coronary heart disease, diabetes, chronic kidney disease, and asthma. According to some statistical data, approximately 50% of SH patients had previously undergone abdominal surgery [1,2,5,6].…”

Section: Discussionmentioning

confidence: 99%