2017 Volume 42 Issue 6 Pages 1063-1066
A 70ʼs man visited our outpatient clinic for painless bulging in the left groin and right lateral abdomen. The patient was diagnosed with a left inguinal hernia with an orifice size of 1.5 finger widths and a Spigelian hernia with an orifice size of 1 finger width. As there was no sign of incarceration, the patient was scheduled for elective surgery. Transabdominal preperitoneal (TAPP) repair was selected to treat the two lesions in one stage. A camera port was inserted in the umbilical area. Intraperitoneal observation revealed a left direct inguinal hernia, a right Spigelian hernia, and another left Spigelian hernia that had not been identified preoperatively. The TAPP method was performed for the groin hernia on schedule. Direct closure of the hernia orifices was performed for both Spigelian hernias because the orifices were small. The postoperative course was favorable, and the patient was discharged on postoperative day 4. A Spigelian hernia is a relatively rare abdominal wall hernia. In this case, laparoscopic observation enabled us to identify and treat a hernia that had not been diagnosed preoperatively. This case highlights the significance of intraperitoneal observation during laparoscopic surgery, and we report the case with a literature review.
