Single-incision retroperitoneal laparoscopic repair of superior lumbar hernia using self-fixating ProGrip mesh: A case report

Abstract

IntroductionLumbar hernia is rare and represents less than 1–2% of all abdominal hernias. There are mainly two types of lumbar hernia: superior lumbar hernia and inferior lumbar hernia. Case presentationA 65-year-old woman was admitted complaining of a mass in her left lumbar area. Under a diagnosis of superior lumbar hernia, single-incision laparoscopic retroperitoneal repair was performed. A single, 2-cm-long incision was made and the retroperitoneal space was dissected gradually. The hernia orifice was recognized and hernia sac was slipped from the hernia orifice. The collateral branch of subcostal nerve and iliohypogastric nerve were recognized. Laparoscopic self-fixating mesh was placed to cover the hernia orifice without mesh fixation. The patient remained well with no signs of recurrence. DiscussionIn laparoscopic lumbar hernia repair, it is important to be careful not to damage subcostal nerve and iliohypogastric nerve. Self-fixating mesh without fixation is useful due to the prevention from nerve injury. To our best knowledge, this is the first report of single-incision laparoscopic repair for superior lumbar hernia. Single-incision laparoscopic surgery could provide good cosmetic results with minimal incision. ConclusionWe successfully performed single-incision retroperitoneal laparoscopic repair of superior lumbar hernia using self-fixating mesh.