A case of Spigelian hernia treated with totally extraperitoneal hernia repair after lateral interbody fusion Masanori NAKAMURA 1 , Takuya WATANABE 1 , Naoki MASHITA 1 , Junichi TOBINAGA 1 , Akira NONOGAKI 1 , Hisafumi SAITO 1 1Department of Surgery, Konan Kosei Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives Keyword: 側方経路腰椎椎体間固定術 , Spigelian hernia , Totally extraperitoneal法 , TEP法 pp.21-28
Published Date 2020/1/15
DOI https://doi.org/10.11477/mf.4426200767
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 A 78-year-old woman was admitted to our hospital for a bulging in her left lower quadrant subsequent to lateral interbody fusion for lumbar spinal canal stenosis. We could not confirm whether the bulging originated in the abdomen's subcutaneous tissue or a hernia orifice during clinical examination. However, abdominal computed tomography findings were suggestive of Spigelian hernia because the intestinal tract had prolapsed between the outer layer of the left rectus abdominis muscle and the transverse abdominis muscle. Totally extraperitoneal (TEP) hernia repair was performed. The peritoneal anterior cavity was peeled off in the caudal direction, and the abdominal transverse muscles on the outer side and the Cooper ligament on the inside were identified. An exterior defect of the abdominal transversalis aponeurosis was found 2 cm from the left internal inguinal ring. We confirmed the diagnosis of Spigelian hernia based on the intraoperative findings. TEP was effective for Spigelian hernia after spinal surgery through the retroperitoneal approach.

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