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Case Reports
. 2021 May 18;21(1):245.
doi: 10.1186/s12893-021-01237-9.

Laparoscopic perineal hernia repair following pelvic exenteration: a case report

Méryl Dahan  1   2 , David Krief  3 , Nicolas Pouget  3 , Roman Rouzier  3   4   5
Affiliations
Case Reports

Laparoscopic perineal hernia repair following pelvic exenteration: a case report

Méryl Dahan et al. BMC Surg. .

Abstract

Background: Acquired perineal hernia is a rare complication following extensive pelvic surgery. Radiotherapy is also a predisposing factor. Perineal hernia can cause chronic perineal pain, bowel obstruction, urinary disorders and a cosmetically disfiguring defect. The treatment of perineal hernia is surgical, usually consisting of mesh repair via an abdominal or perineal approach.

Case presentation: We present a case report and a surgical video of a 42-year-old woman with history of a squamous cell carcinoma. This patient had 3 recurrences since the diagnosis and a symptomatic perineal hernia. Complete regression of the recurrent malignancy allowed us to treat the perineal hernia. We performed laparoscopic repair with prosthetic mesh in this patient who had undergone multiple surgeries and radiotherapy, while preserving the omental flap that was used to reconstruct the posterior part of the vagina.

Conclusion: There is no consensus concerning the preferred surgical approach, perineal or laparoscopic, as no study has demonstrated the superiority of either of these approaches. Laparoscopic repair for an acquired perineal hernia is safe and feasible. However, further studies including randomized trials are required to precisely evaluate the best surgical approach and type of mesh.

Keywords: Abdominoperineal excision; Case report; Laparoscopy; Perineal hernia; Prosthetic mesh.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Sagittal pelvic MRI of the perineal hernia
Fig. 2
Fig. 2
Sagittal pelvic MRI at 6 months follow-up
See this image and copyright information in PMC

References

    1. Narang SK, Alam NN, Köckerling F, Daniels IR, Smart NJ. Repair of perineal hernia following abdominoperineal excision with biological mesh: a systematic review. Front Surg. 2016;3:49. doi: 10.3389/fsurg.2016.00049. - DOI - PMC - PubMed
    1. Drissi et al. Perineal hernias: diagnosis, management, prevention. e-mémoires de l'Académie Nationale de Chirurgie, 2017;16(2):065–068.
    1. McKenna NP, Habermann EB, Larson DW, Kelley SR, Mathis KL. A 25 year experience of perineal hernia repair. Hernia. 2020;24(2):273–278. doi: 10.1007/s10029-019-01958-0. - DOI - PubMed
    1. Aboian E, Winter DC, Metcalf DR, Wolff BG. Perineal hernia after proctectomy: prevalence, risks, and management. Dis Colon Rectum. 2006;49(10):1564–1568. doi: 10.1007/s10350-006-0669-0. - DOI - PubMed
    1. Yeoman FC. Levator hernia, perineal and pudendal. Am J Surg. 1939;43:695–697. doi: 10.1016/S0002-9610(39)90626-4. - DOI

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