Laparoscopic Management of Spigelian Hernias

Spigelian Hernias were first described by Josef Klinkosch in 1764 and named after Adriaan von Spieghel the Flemish anatomist who was the first to describe the linea semilunaris. Spigelian Hernias are the most common of the lateral ventral hernias but only account for 1%-2% of all hernias. These hernias most commonly present between the 4th and 7th decade with most patients having previous abdominal operations or chronic conditions which lead to increased intra-abdominal pressure.
Our patient is a 61-year-old male with a history of Graves’ disease, which was treated by radioactive iodine and a primary repair of an umbilical hernia in 2002. He presented to the ED with 4 days of abdominal pain, bloating, nausea, vomiting, and abdominal distention. All of his laboratory studies and vital signs were normal. Physical Exam demonstrated pain in the left lower quadrant with an associated mass, no abdominal rebound, guarding, or peritoneal signs. CT scans confirmed the presence of an incarcerated Spigelian Hernia. The patient was taken to the operating room where he underwent laparoscopic primary repair of his incarcerated Spigelian Hernia.
Laparoscopic management of incarcerated Spigelian hernia is presented. This minimally invasive approach has less postoperative pain and earlier recovery. Additionally, compared to the open repair, the external oblique aponeurosis is preserved which maintains the abdominal wall strength and potentially avoids subsequent development of incisional hernia.

Session: Podium Video Presentation

Program Number: V007

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