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ORIGINAL ARTICLE
Year : 2018  |  Volume : 37  |  Issue : 4  |  Page : 445-452

Laparoscopic intraperitoneal onlay mesh for Spigelian hernia repair: a prospective study


1 Department of General Surgery, College of Medicine, Ain-Shams University, Cairo; Department of General and Laparoscopic Surgery, Abha, Egypt
2 Department of General Surgery, College of Medicine, Ain-Shams University, Cairo; Department of Diagnostic Radiology, Abha Private Hospital, Abha, Egypt

Correspondence Address:
Tarek A.O Abouzeid
Department of Surgery, Ain-Shams University, 17 Street Abd-Alhady Ghazaly, Alshark, Port-Said 42511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_41_18

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Background Spigelian hernia is a rare variant of the ventral hernia protruding from a small defect in the Spigelian fascia. The surgical treatment is recommended once diagnosed. Objective In this study, we tried to spotlight on this mysterious disease as a cause of vague abdominal pain, evaluating the laparoscopic intraperitoneal onlay mesh (IPOM) technique as regards the efficacy and complications. Patients and methods A prospective study had been conducted at the Abha Private Hospital, Abha, Saudi Arabia, on 10 consecutive patients who suffered from Spigelian hernia, between 1 June 2015 and 31 December 2017. The patients were scheduled for laparoscopic IPOM using a composite mesh (Symbotex). Results During the period of the study, 10 patients had undergone 11 IPOM (one bilateral hernia); the mean age of the patients was 63.7 years (range: 37–82 years). The preoperative diagnosis was made in nine (81.8%) patients. The reformatted thin-cut axial computed tomographic scan with multiplanar reformatted modality was found to be more sensitive than the superficial ultrasound (81.8 vs. 72.7%). The laparoscopic IPOM is a fast procedure (average: 44.7 min), and was associated with relatively short postoperative hospital stay (average: 1.2 days). Only one patient developed chronic pain related to the mesh. No recurrence has been detected during a follow-up period of 6 months. Conclusion The Spigelian hernia is a rare type of ventral hernia. Reformatted computed tomographic scan is the best imaging modality. Although the open approach is the classic way of treatment, laparoscopic IPOM has been shown to be a safe, fast, and efficient alternative.


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