Title

Emergency intraperitoneal onlay mesh repair of incarcerated Spigelian hernia

Date of this Version

4-1-2010

Document Type

Journal Article

Publication Details

Interim status: Citation only.

Subramanya, M. S., Chakraborty, J., Memon, B., & Memon, M. A. (2010). Emergency intraperitoneal onlay mesh repair of incarcerated Spigelian hernia. Journal of Society of Laparoendoscopic Surgeons, 14(2), 275-278.

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2010 HERDC submission. FoR Code: 110300

© Copyright 2010 by JSLS, Journal of Society of Laparoendoscopic Surgeons. Published by the Society of Laparoendoscopic Surgeons, Inc.

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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This document has been peer reviewed.