Laparoscopic Repair of Perineal Hernia Using a Double-Mesh Technique

Abstract

Introduction Perineal herniation following pelvic surgery, including abdomino-perineal resection (APR) and pelvic exenteration is a rare condition but can present with serious complications. Multiple methods of repair are possible including either an abdominal or perineal approach. Laparoscopic abdominal repairs have been described. Case Presentation An 83 year-old lady, under follow-up following a laparoscopic APR two years previously for a T2N0M0 low rectal cancer, presented with a symptomatic perineal hernia which caused significant impairment in her daily living activities. She had no major comorbidities and was keen for intervention. She was electively admitted for a laparoscopic repair of perineal hernia. This was performed using a double-mesh technique, which allows strengthening of the repair as a feasible alternative to consider in repair of this difficult complication. Conclusions This technique is feasible as an alternative to standard laparoscopic or perineal repair of perineal herniation. Further studies are required to demonstrate its long-term efficacy.