Abstract
IntroductionA superior lumbar hernia, which is also known as a Grynfeltt hernia, is a rare abdominal wall defect that can be primary or secondary to trauma or orthopedic surgery. The anatomic location of a lumbar hernia makes diagnosis and repair challenging. We successfully repaired a lumbar hernia using a single-incision laparoscopic total extraperitoneal approach. To the best of our knowledge, this is the first report of the use of this surgical technique in the treatment of a primary Grynfeltt hernia.Case presentationA 76-year-old Taiwanese man presented to our hospital with a left lower bulging mass noted for over three months. Abdominal computed tomography revealed a left Grynfeltt hernia. We performed a single-incision laparoscopic total extraperitoneal repair. Our patient was discharged uneventfully on the fourth day after the operation. There was no evidence of recurrence after six months of follow-up.ConclusionA laparoscopic total extraperitoneal repair for a lumbar hernia provides an excellent operative view and minimal invasiveness. The single-incision technique also provides better cosmetic outcomes. Our experience suggests that the single-incision laparoscopic total extraperitoneal approach may be a feasible and safe alterative to conventional approaches in lumbar hernia repair.
Highlights
A superior lumbar hernia, which is known as a Grynfeltt hernia, is a rare abdominal wall defect that can be primary or secondary to trauma or orthopedic surgery
Our experience suggests that the single-incision laparoscopic total extraperitoneal approach may be a feasible and safe alterative to conventional approaches in lumbar hernia repair
A lumbar hernia is a rare type of abdominal wall defect over the lumbar triangles that can be categorized into superior (Grynfeltt) and inferior (Petit) by anatomic location
Summary
Compared with the open and intraperitoneal laparoscopic approaches, laparoscopic total extraperitoneal repair for a lumbar hernia provides an excellent operative view and minimal invasiveness. The single-incision technique provides better cosmetic outcomes. Our experience suggests that the single-incision laparoscopic total extraperitoneal approach may be a feasible and safe alternative to the conventional approaches in lumbar hernia repair. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. Authors’ contributions CTW carried out collection and assembly of data, data analysis and interpretation, and manuscript writing. KCH was responsible for the conception and design, provision of study material or patients, collection and assembly of data, data analysis and interpretation, and final approval of the manuscript. All authors read and approved the final manuscript
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