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Case Reports
. 2014 Sep-Oct;99(5):556-9.
doi: 10.9738/INTSURG-D-13-00135.1.

Petit lumbar hernia--a double-layer technique for tension-free repair

André Vicente Bigolin  1 , André Petter Rodrigues, Camila Gueresi Trevisan, Ana Brochado Geist, Roberto Viña Coral, Natalino Rinaldi, Roberto Pelegrini Coral
Affiliations
Case Reports

Petit lumbar hernia--a double-layer technique for tension-free repair

André Vicente Bigolin et al. Int Surg. 2014 Sep-Oct.

Abstract

This report describes an alternative technique for Petit hernia repair. The treatment of lumbar hernias should follow the concept of tension-free surgery, and the preperitoneal space can be the best place for prosthesis placement. An obese patient had a bulge in the right lumbar region, which gradually grew and became symptomatic, limiting her daily activities and jeopardizing her quality of life. She had previously undergone 2 surgical procedures with different incisions. We created a preperitoneal space and attached a mesh in this position. Another prosthesis was placed on the muscles, with a suitable edge beyond the limits of the defect. There were no complications. It has been described as a safe and tension-free repair for Petit hernia. In larger defects, a second mesh can be used to prevent further enlargement of the triangle and also to provide additional protection beyond the bone limits.

Keywords: Hernia; Lumbar hernia; Open repair; Prosthetic mesh repair.

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Figures

Fig. 1
Fig. 1
(a) Large hernia sac after dissection of the subcutaneous tissue. (b) Scheme representing a transverse anatomical view of the hernia sac protruding through the Petit's triangle. T, transversum abdominis muscle; IO, internal oblique muscle; E, external oblique muscle; LD, latissimus dorsi muscle.
Fig. 2
Fig. 2
(a) Petit's triangle after placement of sublay mesh. (b) Scheme representing a transverse anatomical view of the position of the sublay mesh and the transfixing stitches. E, external oblique muscle; LD, latissimus dorsi muscle.
Fig. 3
Fig. 3
Final aspect with onlay mesh.
See this image and copyright information in PMC

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