Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia: A case report

Shimpei Matsui, Nobuhiro Nitori, Ayu Kato, Yoshifumi Ikeda, Yuko Kiatagwa, Hirotoshi Hasegawa, Koji Okabayashi, Masashi Tsuruta, Masaki Kitajima

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction Spigelian hernia (SH) is a rare ventral hernia occurring near the lateral border of the rectus muscle. The treatment remains controversial and depends on institutional expertise. Although laparoscopic surgery is a good adaptation for the repair of ventral hernias, only a few cases have been reported in the literature. Here, we report a case of totally extra-peritoneal (TEP) repair for bilateral SHs. Presentation of case A 74-year-old Japanese man presented with asymptomatic bulges in the right lower abdominal quadrant. On physical examination, the bulges were located to the right of the lateral border of the abdominal rectus muscle and the right inguinal region in an upright position. We diagnosed right SH and coincident homonymous ipsilateral inguinal hernia (IH) by abdominal computed tomography and planned a curative operation by laparoscopy. By first laparoscopic exploration, we found an asymptomatic SH to the left of the lateral border of the abdominal rectus muscle and performed TEP repair for all hernias. The second laparoscopic exploration after fixing the mesh in place revealed that the orifice of the right SH was scarred and stiffened by repeated prolapse. We finally eliminated the sac by ligation because of a fear causing of reduction en masse of the SH. Discussion and conclusion The use of laparoscopy simplified the diagnosis and facilitates the subsequent repair of the hernia. TEP approach is the ideal treatment for the simultaneous laparoscopic repair of SH and IH.

Original languageEnglish
Pages (from-to)169-172
Number of pages4
JournalInternational Journal of Surgery Case Reports
Volume28
DOIs
Publication statusPublished - 2016

Fingerprint

Inguinal Hernia
Herniorrhaphy
Hernia
Laparoscopy
Ventral Hernia
Abdominal Muscles
Groin
Prolapse
Physical Examination
Fear
Ligation
Tomography
Muscles
Therapeutics

Keywords

  • Case report
  • Laparoscopic totally extra-peritoneal hernia repair
  • Reduction en masse
  • Spigelian hernia

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia : A case report. / Matsui, Shimpei; Nitori, Nobuhiro; Kato, Ayu; Ikeda, Yoshifumi; Kiatagwa, Yuko; Hasegawa, Hirotoshi; Okabayashi, Koji; Tsuruta, Masashi; Kitajima, Masaki.

In: International Journal of Surgery Case Reports, Vol. 28, 2016, p. 169-172.

Research output: Contribution to journalArticle

Matsui, Shimpei ; Nitori, Nobuhiro ; Kato, Ayu ; Ikeda, Yoshifumi ; Kiatagwa, Yuko ; Hasegawa, Hirotoshi ; Okabayashi, Koji ; Tsuruta, Masashi ; Kitajima, Masaki. / Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia : A case report. In: International Journal of Surgery Case Reports. 2016 ; Vol. 28. pp. 169-172.
@article{415a5c6e8c964d12ab83f7cf212b8b88,
title = "Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia: A case report",
abstract = "Introduction Spigelian hernia (SH) is a rare ventral hernia occurring near the lateral border of the rectus muscle. The treatment remains controversial and depends on institutional expertise. Although laparoscopic surgery is a good adaptation for the repair of ventral hernias, only a few cases have been reported in the literature. Here, we report a case of totally extra-peritoneal (TEP) repair for bilateral SHs. Presentation of case A 74-year-old Japanese man presented with asymptomatic bulges in the right lower abdominal quadrant. On physical examination, the bulges were located to the right of the lateral border of the abdominal rectus muscle and the right inguinal region in an upright position. We diagnosed right SH and coincident homonymous ipsilateral inguinal hernia (IH) by abdominal computed tomography and planned a curative operation by laparoscopy. By first laparoscopic exploration, we found an asymptomatic SH to the left of the lateral border of the abdominal rectus muscle and performed TEP repair for all hernias. The second laparoscopic exploration after fixing the mesh in place revealed that the orifice of the right SH was scarred and stiffened by repeated prolapse. We finally eliminated the sac by ligation because of a fear causing of reduction en masse of the SH. Discussion and conclusion The use of laparoscopy simplified the diagnosis and facilitates the subsequent repair of the hernia. TEP approach is the ideal treatment for the simultaneous laparoscopic repair of SH and IH.",
keywords = "Case report, Laparoscopic totally extra-peritoneal hernia repair, Reduction en masse, Spigelian hernia",
author = "Shimpei Matsui and Nobuhiro Nitori and Ayu Kato and Yoshifumi Ikeda and Yuko Kiatagwa and Hirotoshi Hasegawa and Koji Okabayashi and Masashi Tsuruta and Masaki Kitajima",
year = "2016",
doi = "10.1016/j.ijscr.2016.09.053",
language = "English",
volume = "28",
pages = "169--172",
journal = "International Journal of Surgery Case Reports",
issn = "2210-2612",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia

T2 - A case report

AU - Matsui, Shimpei

AU - Nitori, Nobuhiro

AU - Kato, Ayu

AU - Ikeda, Yoshifumi

AU - Kiatagwa, Yuko

AU - Hasegawa, Hirotoshi

AU - Okabayashi, Koji

AU - Tsuruta, Masashi

AU - Kitajima, Masaki

PY - 2016

Y1 - 2016

N2 - Introduction Spigelian hernia (SH) is a rare ventral hernia occurring near the lateral border of the rectus muscle. The treatment remains controversial and depends on institutional expertise. Although laparoscopic surgery is a good adaptation for the repair of ventral hernias, only a few cases have been reported in the literature. Here, we report a case of totally extra-peritoneal (TEP) repair for bilateral SHs. Presentation of case A 74-year-old Japanese man presented with asymptomatic bulges in the right lower abdominal quadrant. On physical examination, the bulges were located to the right of the lateral border of the abdominal rectus muscle and the right inguinal region in an upright position. We diagnosed right SH and coincident homonymous ipsilateral inguinal hernia (IH) by abdominal computed tomography and planned a curative operation by laparoscopy. By first laparoscopic exploration, we found an asymptomatic SH to the left of the lateral border of the abdominal rectus muscle and performed TEP repair for all hernias. The second laparoscopic exploration after fixing the mesh in place revealed that the orifice of the right SH was scarred and stiffened by repeated prolapse. We finally eliminated the sac by ligation because of a fear causing of reduction en masse of the SH. Discussion and conclusion The use of laparoscopy simplified the diagnosis and facilitates the subsequent repair of the hernia. TEP approach is the ideal treatment for the simultaneous laparoscopic repair of SH and IH.

AB - Introduction Spigelian hernia (SH) is a rare ventral hernia occurring near the lateral border of the rectus muscle. The treatment remains controversial and depends on institutional expertise. Although laparoscopic surgery is a good adaptation for the repair of ventral hernias, only a few cases have been reported in the literature. Here, we report a case of totally extra-peritoneal (TEP) repair for bilateral SHs. Presentation of case A 74-year-old Japanese man presented with asymptomatic bulges in the right lower abdominal quadrant. On physical examination, the bulges were located to the right of the lateral border of the abdominal rectus muscle and the right inguinal region in an upright position. We diagnosed right SH and coincident homonymous ipsilateral inguinal hernia (IH) by abdominal computed tomography and planned a curative operation by laparoscopy. By first laparoscopic exploration, we found an asymptomatic SH to the left of the lateral border of the abdominal rectus muscle and performed TEP repair for all hernias. The second laparoscopic exploration after fixing the mesh in place revealed that the orifice of the right SH was scarred and stiffened by repeated prolapse. We finally eliminated the sac by ligation because of a fear causing of reduction en masse of the SH. Discussion and conclusion The use of laparoscopy simplified the diagnosis and facilitates the subsequent repair of the hernia. TEP approach is the ideal treatment for the simultaneous laparoscopic repair of SH and IH.

KW - Case report

KW - Laparoscopic totally extra-peritoneal hernia repair

KW - Reduction en masse

KW - Spigelian hernia

UR - http://www.scopus.com/inward/record.url?scp=84990833618&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990833618&partnerID=8YFLogxK

U2 - 10.1016/j.ijscr.2016.09.053

DO - 10.1016/j.ijscr.2016.09.053

M3 - Article

AN - SCOPUS:84990833618

VL - 28

SP - 169

EP - 172

JO - International Journal of Surgery Case Reports

JF - International Journal of Surgery Case Reports

SN - 2210-2612

ER -