2017 Volume 37 Issue 3 Pages 421-425
Recently, the number of cases of lumbar hernia repaired using artificial materials has increased based on the concept of tension-free repair, as has been widely applied for inguinal hernia repair. Herein, we report the case of a superior lumbar hernia repaired using the ULTRAPRO plug(UPP). An 87-year-old woman complaining of a left lower back mass was referred to our hospital. On physical examination, a soft and painless mass, 7×5 cm in diameter, was confirmed in her left lower lumbar area. Manual reduction of the hernia content was possible. An abdominal computed tomography scan revealed that the descending colon had prolapsed into the extraperitoneal fat layer through a left lumbar muscle defect, which was diagnosed as a superior lumbar hernia. Operative findings revealed a hernia sac under the broadest muscle of back. The hernia orifice was confirmed as the superior lumbar triangle surrounded by the 12th rib, the serratus posterior inferior, the internal oblique muscle, and the quadratus lumborum muscle. The hernia orifice measured 3.5 cm in diameter. Hernia repair was performed using a UPP. The postoperative course was uneventful, and the patient was discharged on the 3rd post-operative day. The patient has been in good health without signs of recurrence for 2 years since the surgery. Because a partially absorbable soft mesh, such as a UPP, can be easily adjusted to the hernia orifice without causing postoperative pain, UPP appears to be useful for the repair of superior lumbar hernias.
