Abstract

Spigelian hernia (SH) is uncommon and accounts for only 0.12–2% of all abdominal hernias. Spigelian hernia is a protrusion through a defect in the aponeurosis of the transversus abdominis muscle (Spigelian fascia) that is limited by the semilunar line and the lateral edge of the rectus abdominis muscle. It is more common in women 50–60 years and it is twice as common on the right side. Patients may present with non-specific abdominal pain. Clinical diagnosis may be difficult, especially in obese patients, and radiologic exams are essential to obtain the correct diagnoses. This type of hernia has a mandatory indication to surgical repair due to the risk of incarceration that can occur in about 25% and strangulation that can occur in about 40%. Traditionally, open surgical repair is most commonly used. However, laparoscopic approach is becoming increasingly popular since it allows faster recovery, shorter hospital stay, and less pain, with no commitment to recurrence. Currently, there are no studies that demonstrate the superiority of a laparoscopic technique (intraperitoneal onlay mesh (IPOM), transabdominal pre-peritoneal (TAPP) or extraperitoneal approach (TEP)). The intraperitoneal route is a simple, faster, and easily reproducible approach.

Highlights

  • A hernia occurs when there is an abnormal protrusion of an organ or tissue through a natural orifice or weakness point

  • This zone is known as the “Spigelian hernia belt” and is defined medially by the lateral border of the rectus abdominis muscle, superiorly by the arcuate line and inferiorly by the inferior epigastric vessels [2–8]

  • The use of synthetic mesh is recommended, as it guarantees better results when compared with suture of the hernia defect [4, 11]

Read more

Summary

Introduction

A hernia occurs when there is an abnormal protrusion of an organ or tissue through a natural orifice or weakness point. Spigelian hernias (SH) are defined as a protrusion of preperitoneal fat, peritoneum or an organ through a defect that can be acquired or congenital, located laterally to the rectus abdominis in the anterior abdominal wall [2, 3]. This type of hernia is rare and has been estimated to account for

Anatomy
Incidence
Pathophysiology and risk factors
Clinical presentation
Complementary diagnostic exams
Abdominal X-ray
Ultrasonography (US)
Computed tomography (CT)
Differential diagnosis
Treatment
Open approach
Laparoscopic approach
Intraperitoneal onlay mesh
Transabdominal preperitoneal approach
Total extraperitoneal
Robotic surgery
Findings
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call