Abstract
Spigelian hernias are very rarely encountered, accounting for 0.12^2% of all abdominal hernias. We report herein on a case of incarcerated Spigelian hernia repaired with the ULTRAPROTM Hernia System (UHS). A 75-year-old man presented with left lower abdominal pain. He had a history including both a gastrectomy and a bilateral inguinal hernioplasty. Abdominal computed tomography showed an incarcerated lower abdominal wall hernia lateral to the left rectus abdominis muscle. Reduction of the hernia content by hands was impossible, therefore an emergency operation was indicated. Operative findings showed that the hernia orifice was located in the Spigelian aponeurosis with a lateral extension to the internal oblique muscle. We applied UHS, a light-weight, partially absorbable mesh device, for the repair. The underlay patch was positioned in the preperitoneal space and the onlay patch above the Spigelian aponeurosis and the internal oblique muscle, while the connector obliterated the hernia orifice. The patient's postoperative course was uneventful, and the pain was minimal. We conclude that UHS is a useful device for Spigelian hernia repair.
