Laparoscopic Grynfeltt Hernia Repair

BACKGROUND
Lumbar hernias are rare. Laparoscopic lumbar hernia repair was first described in 1996 by Burick and Parascandola. In 2005, the first publication comparing open versus laparoscopic lumbar hernia repair was published by Moreno-Egea of Spain. Various techniques have been described during this time period. Given their posterior nature and relationship to critical vascular, neurological and urological structures, repair of these hernias can be challenging. This video demonstrates a case of laparoscopic Grynfeltt hernia repair.
TECHNIQUE
Our right lateral abdominal wall dissection extended from the right triangular ligament near the diaphragm down to the cecum following the line of toldt (cephalad to caudal orientation). The right kidney was dissected out the retroperitoneal space. The right colon, hepatic flexure and right kidney were rotated medially. A large 15×15 cm mesh was placed over a 5x3cm defect. This was secured in place by use of gore-tex sutures, titanium tacks and tisseal (fibrin glue).
RESULTS
Operative time was 1.5 hour with an estimated blood loss of 25cc. The operative course was uncomplicated.
DISCUSSION
Our video demonstrates the technical feasibility of a laparoscopic Grynfeltt hernia repair.

Session: Podium Video Presentation

Program Number: V009