Open Surgery for Spiegel's Hernia

Abstract

Spiegel's hernias are uncommon anomalies in the Spiegel's aponeurosis, which runs between the rectus muscle and the semilunar line. They are most commonly found in the "Spigel's hernia belt" between the navel and the interspinal line (a horizontal line connecting the anterosuperior iliac spines). We recommend open repair for individuals who arrive with an acute Spiegel's hernia, especially if there is a risk of high-grade blockage, strangulation, intra-abdominal infection, and/or the necessity for bowel resection. Furthermore, open repair may be required due to the surgeon's lack of expertise with and/or experience with laparoscopic methods, or when laparoscopy is contraindicated due to an inability to tolerate pneumoperitoneum or securely access the peritoneal cavity. Sutures or mesh can be used to repair an open Spiegel's hernia. Given the risk of recurrence, we only do suture repair in cases of contamination when mesh implantation is contraindicated and may enhance morbidity.