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Lumbar Hernia Repair: A Transabdominal Laparoscopic Approach with Extraperitoneal Mesh Placement

Robert A Grossman, MD, Daniel Bergholz, BA. Mount Sinai Medical Center

Introduction: Lumbar hernias are rare abdominal wall defects. Fewer than 400 cases have been reported in the literature, and account for 2% of all abdominal wall hernias. Lumbar hernias are divided into Grynfelt-lesshaft or Petit hernias. The former are hernia defects through the superior lumbar triangle, while the latter are defects of the inferior lumbar triangle. Primary lumbar hernias are further subdivided into congenital and acquired hernias that can be classified as either primary or secondary. Secondary hernias occur after previous flank surgeries, iatrogenic muscular disruption, infection, or trauma.

Method: We review a rare presentation of metachronous symptomatic bilateral secondary acquired lumbar hernia following spine surgery. A successful laparoscopic trans-abdominal lumbar hernia repair with extra peritoneal mesh placement was performed, with resolution of the hernia symptoms.

Conclusion: Acquired lumbar hernias are extremely rare; most general surgeons may not encounter a case in their careers. Bilateral lumbar hernia following spinal fusion surgery has not been well described in the literature, and as such there is no clear guideline for management. Different surgical techniques to repair lumbar hernias have been described. We present a successful repair of a right-sided Grynfelt hernia using trans-abdominal laparoscopic retroperitoneal mesh placement.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95700

Program Number: V309

Presentation Session: Video Loop Day 3

Presentation Type: VideoLoop

Post Views: 27

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