Laparoscopic Repair of Spigelian Hernia: Our Experience

Abstract

Spigelian hernias are rare abdominal wall hernias occurring through a defect in the spigelian fascia lateral to the semilunar lines and pose great difficulty in diagnosis due to their location and varied presentations. The treatment of spigelian hernia has evolved from open surgical repair to laparoscopic hernioplasty. In this article, we share our experience of 6 patients with spigelian hernia managed by laparoscopic mesh repair and review the related literature on the topic. A retrospective data collection of patients of spigelian hernia operated on between January 2005 and December 2008 was done. The data were evaluated regarding patient presentation, age group, methods of surgical repair, and the outcome of the procedures. The patients had follow-up at 1 week, 6 months, 1 year, and 2 years after the surgery and were evaluated for any recurrence or mesh-related complications. In total, 6 patients of spigelian hernia were operated on in 4 years, from January 2005 to December 2008, with most of them presenting with either a lump or pain. All patients were operated by the transabdominal preperitoneal (TAPP) method with satisfactory results. No recurrences were found in 2 years of follow-up. Laparoscopic TAPP is an acceptable method of spigelian hernia repair with good results and low recurrence rates. However, long-term follow-up studies are required to assess the late recurrence rate.