Laparoscopic repair of lumbar hernia with Parietex Mesh using Quills Suture.

Fernado Dip, MD, Hira Ahmad, MD, Emanuele Lo Menzo, MD, PhD, FACS, Samuel Szomstein, MD, FACS, Raul Rosenthal, MD, FACSASMBS. Cleveland Clinic Florida.

 Background: Lumbar hernias are a rare entity. Repair with mesh via and open or laparoscopic approach are the most accepted definitive treatment modalities.. When using a laparoscopic approach, the fixation of the mesh has not been standardized. We present a tension free repair technique with a non absorbable mesh using a non absorbable barbed suture.

Methods: 58- year- old male with a symptomatic lumbar hernia after a partial nephrectomy presented for repair. The abdominal cavity was accessed using Hasson’s technique; accessory 12 and 5-mm trocars were placed in the supraumbilical midline, as well as in the right mid lower quadrant of the abdomen. The omental adhesions of the colon adhered to the hernia ring were taken down using cold scissors and Harmonic Scalpel. Thorough hemostasis was achieved and hernia defect was closed with a circular Parietex mesh (20 cm x 15 cm) with abundant overlapping using interrupted and running 2 Prolene Quill suture.

Results: The patient tolerated diet on the same diet of surgery. hHs pain was well controlled and was discharged home on postoperative day 1.

Conclusion: Laparoscopic fixation of non absorbable mesh with non absorbable barbed sutures appears to be a feasible technique and a good alternative to tackers.

« Return to SAGES 2014 abstract archive