Laparoscopic Tapp Repair of Grynfeltt Hernia

Christian G Massier, MD, Carl Yood, MD. Cleveland Clinic, Cleveland, Ohio

 

Purpose
A very simple laparoscopic technique to repair a superior lumbar hernia is described.

Method
The case of an 67-year-old patient with a symptomatic Grynfelt lumbar hernia is reported. The diagnosis was made by physical examination and confirmed by computed tomography scan.

Results
The defect of the posterior abdominal wall was closed via a pro-peritoneal mesh repair. Repairing these hernias is difficult due to the surrounding structures. Principles of laparoscopic repair are described and include lateral decubitus positioning with table flexed, adhesiolysis, and reduction of hernia contents, securing the mesh to the intercostal space superiorly, lumbar muscle posteriorly, and oblique muscle anteriorly while avoiding injury to neurovascular structures.

Conclusions
The surgical approach described in this video is simple and easy to perform, and its result is comparable with other techniques that are much more sophisticated. The laparoscopic approach provides an attractive option for this often challenging problem.
 


Session Number: VidTV3 – Video Channel Rotation Day 3
Program Number: V124

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