V-027 2-IN1: LAPAROSCOPIC TAPP REPAIR OF CONCURRENT SPIGELIAN AND INGUINAL HERNIAS

Abstract

Abstract Aim Spigelian hernias are rare hernias of the abdominal wall and difficult to diagnose clinically. Our aim is to report a diagnostic and surgical challenge of the combination of inguinal and Spigelian hernias. Material & Methods 74 year old female presented with pain in right inguinal region and lump in right iliac fossa. The ultrasound scan revealed right sided Spigelian hernia up to 4 cm, right inguinal hernia up to 1 cm and incidentally detected contralateral Spigelian hernia up to 3 cm on the left side. Results Laparoscopic transabdominal preperitoneal (TAPP) hernia repair was performed of both right Spigelian and ipsilateral inguinal hernias. The hernia sacs were dissected and 25×15 cm polypropylene mesh was placed, covering both hernia sites. The mesh was fixed using absorbable tacks. The peritoneum was closed using barbed suture. The repair of contralateral Spigelian hernia was planned as a second stage procedure due to the present comorbidities. Operation time was 140 min. The patient was discharged on the next postoperative day. Ultrasound scan performed after 3 weeks did not show any signs of seroma, hematoma or recurrence. Conclusions An accurate preoperative diagnosis of Spigelian and inguinal hernias led to the safe and successful laparoscopic repair with preperitoneal mesh placement.