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Case Reports
. 2010 Apr-Jun;14(2):275-8.
doi: 10.4293/108680810X12785289144683.

Emergency intraperitoneal onlay mesh repair of incarcerated spigelian hernia

M S Subramanya  1 , J Chakraborty, B Memon, M A Memon
Affiliations
Case Reports

Emergency intraperitoneal onlay mesh repair of incarcerated spigelian hernia

M S Subramanya et al. JSLS. 2010 Apr-Jun.

Abstract

Background and objectives: Spigelian hernia is a rare cause of incarcerated ventral abdominal hernia that may pose a diagnostic dilemma. However, with the increasing utilization of double contrast computed tomography (CT) for undiagnosed small bowel obstruction in a virgin abdomen, more such cases are being diagnosed with increasing confidence. Furthermore, with the rapid expansion of the indications for minimal access surgery in emergency situations, these rare emergencies are increasingly tackled using a laparoscopic approach leading to swift patient recovery and discharge.

Methods: We present the case of an emergency intraperitoneal onlay mesh (IPOM) repair of Spigelian hernia, causing acute small bowel obstruction in a 55-year-old man with liver disease and ascites that was diagnosed using a CT scan. We conducted a search of Medline, Embase, Science Citation Index, Current Contents, PubMed, and the Cochrane Database to review the history of laparoscopic repair of Spigelian hernia and its various advancements, which are briefly presented here.

Results: The hernia was successfully reduced using laparoscopy, revealing a moderate-size defect in the linea semilunaris. The hernial defect was repaired with a composite mesh that was tacked into position. The patient was discharged from the hospital on the second postoperative day.

Conclusions: Spigelian hernia in an emergency setting can be easily and swiftly repaired using the IPOM method utilizing a composite mesh.

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Figures

Figure 1.
Figure 1.
Double contrast CT scan of the abdomen showing the Spigelian hernia location (white arrow) with distended small bowel.
Figure 2.
Figure 2.
Laparoscopic view of the fully incarcerated Spigelian hernia containing the loop of small bowel.
Figure 3.
Figure 3.
Laparoscopic view of the Spigelian hernial defect with small bowel completely reduced into the abdominal cavity.
Figure 4.
Figure 4.
IPOM repair of the Spigelian hernia defect using Bard Ventraliex Hernia Patch secured with Protack.
See this image and copyright information in PMC

References

    1. Memon MA, Fitzgibbons RJ., Jr The role of minimal access surgery in the acute abdomen. Surg Clin North Am. 1997;77:1333–1353 - PubMed
    1. Carter JE, Mizes C. Laparoscopic diagnosis and repair of spigelian hernia: report of a case and technique. Am J Obstet Gynecol. 1992;167:77–78 - PubMed
    1. Larson DW, Farley DR. Spigelian hernias: repair and outcome for 81 patients. World J Surg. 2002;26:1277–1281 - PubMed
    1. Moreno-Egea A, Flores B, Girela E, Martín JG, Aguayo JL, Canteras M. Spigelian hernia: bibliographical study and presentation of a series of 28 patients. Hernia. 2002;6:167–170 - PubMed
    1. Saber AA, Elgamal MH, Rao AJ, Osmer RL, Itawi EA. Laparoscopic spigelian hernia repair: the scroll technique. Am Surg. 2008;74:108–112 - PubMed

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