Day Surgery for Spigelian Hernia Repair Under Local Anesthesia: A “Real Minimally Invasive” Surgical Approach

Abstract

Spigelian hernia (SH) represents less than 1% of all hernias and about 0,1% of abdominal wall hernias. Although it is a very rare hernia, it has a considerably high risk of strangulation. The aim of this work is to propose the open approach based on local anesthesia on a Day Surgery regimen as a safe treatment for Spigelian Hernia surgery. We report a series of 17 clinical cases (9 men and 8 women, between 40 and 80 years old) who underwent SH open repair on a Day Surgery basis between 2004 and 2021 in our University Hospital. In our single-center case series, no early postoperative complications occurred, except for a bulky seroma of about 800 cc. No prosthesis or surgical wound infections occurred and no recurrences were observed in the early postoperative period. Looking at our experience and the literature, Spigelian hernia repair under local anesthesia on a Day Surgery regimen, using a pre-peritoneal polypropylene mesh, could be proposed as a safe and “real minimally invasive” approach in elective settings.