Laparoscopic repair of a perineal hernia

Abstract

Perineal hernias are rare occurrences with statistics ranging from<1 to 3% incidence after open abdominoperineal resection (APR). The incidence of perineal hernia after laparoscopic APR is less certain due to the relatively recent advent of laparoscopic proctectomy. Here we discuss an occurrence of a perineal hernia after a laparoscopic APR and its subsequent laparoscopic repair with mesh. Repair of a perineal hernia can be technically challenging, with a variety of approaches each with its own risk of potential complications. Laparoscopic advancements have allowed a theoretically less invasive approach while having greater view of the necessary anatomical landmarks to achieve safe and tension-free repair of such hernias. There are several case reports available to describe perineal repair but the numbers remain skewed due to the sparse reporting of complications post APR surgery. This may in fact be due to the asymptomatic aspect these hernias can have. Laparoscopic repair is a challenging yet viable approach to the correction of such occurrences.