Matthew L Dong, MD, MPH, Daniel Herron, MD, Gustavo Fernandez-Ranvier, MD. Icahn School of Medicine at Mount Sinai
Introduction: Spigelian hernias are a rare hernia, generally resulting in a defect of the aponeurosis of the transversalis fascia along the semilunar line. They account for 1-2% of all hernias.
Methods and Procedures: In this video, we demonstrate a laparoscopic, transabdominal, preperitoneal repair of a spigelian hernia and an ipsilateral inguinal hernia on a patien with multiple medical comorbidities, including chronic kidney disease, hypertension and undiagnosed congestive hearth failure.
Results: The operation was performed uneventfully. Postoperatively the patient developed a small seroma and was to be managed with watchful waiting. During this period, however, the patient was readmitted with pneumonia, which was subsequently complicated with exacerbation of his chronic kidney disease and previously undiagnosed congestive heart failure. The seroma then increased in size substantially. After confirming that the collection was indeed serous, he was managed with treatment of his medical comordbidities and his seroma rapidly resolved following this.
Conclusion:This video demonstrates a laparoscopic, preperitoneal repair of a spigelian and ipsilateral inguinal hernia, technique for re-peritonealizing using laparoscopic suturing, and conservative management of a large postoperative seroma, exacerbated by the patient's comorbid conditions.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88109
Program Number: V270
Presentation Session: Friday Video Loop (Non CME)
Presentation Type: VideoLoop