Laparoscopic repair of Spigelian hernia : a case report Junpei TOCHIKUBO 1 , Hidetoshi WADA 1 , Masanori SATO 1 , Yuichiro MIYAKI 1 , Takanobu ONODA 1 , Norihiko SHIIYA 1 1First Department of Surgery, Hamamatsu University School of Medicine Keyword: Spigelヘルニア , 半月状線ヘルニア , 腹腔鏡 pp.511-516
Published Date 2012/8/15
DOI https://doi.org/10.11477/mf.4426100820
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 Spigelian hernia is a rare abdominal wall hernia which is generally difficult to diagnose. There are only few reports of laparoscopic Spigelian hernia repair in Japan. A 74-year-old woman visited our hospital because of a bulge on the right lower quadrant. There was a 4×2cm bulge at standing position. Computed tomography showed a thinning of musculoaponeurotic layers at the right outer side of rectus abdominis muscle and a protrusion of fat tissue. Spigelian hernia was suspected and laparoscopic repair was performed. Laparoscopically, the hernia orifice was 1.5×0.5cm at cranial and lateral site, 2cm away from the right internal inguinal ring. The inguinal floor was dissected, and the defect of transverses abdominis aponeurosis was found, confirming the diagnosis of Spigelian hernia. A 13×9cm polyester mesh was placed into the preperitoneal space with tacker fixation. The peritoneum was closed with interrupted sutures. Laparoscopic surgery is useful for the definite diagnosis and the repair of Spigelian hernia, especially for those that are difficult to diagnose by physical examination and imaging findings.

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