V-045 PREPERITONEAL APPROACH FOR BILATERAL SPIGELIAN AND RECURRENT LEFT INGUINAL HERNIAS

Abstract

Abstract This is a case presentation of a preperitoneal repair of a bilateral Spigelian hernia and a recurrent left inguinal hernia. A 71 year old male patient was admitted in the Emergency department after a 3 hour right quadrant acute pain. On his medical record he had an anterior left inguinal repair (Lichtenstein) 6 months before. The physical examination revealed a bulge on the right lower quadrant. The Spigelian hernia was incarcerated but easily reduced. The CT scan findings include a bilateral Spigelian hernia (bowel content), a small umbilical and a left inguinal omental hernia. The patient did not suffer any other incarceration episodes before the surgery, programmed 10 days later. We present the video of the surgical TEP repair, a preperitoneal access, triple hernia reduction, double 15×20cm polypropilene tailored mesh placement. The patient was discharged on the second postoperative day, and had an uneventful recovery with no recurrence after 3 months followup.