Three Cases of Spigelian Hernia Successfully Treated by Surgical Repair with a Mesh

Abstract

Patient #1 was a 70-year-old woman who presented with a left lower abdominal bulge. Abdominal CT showed prolapse of fatty tissue from the groin and a defect in the abdominal wall at the lateral edge of the left rectus abdominis muscle with prolapse of fatty tissue. We diagnosed the patient as having an inguinal hernia as well as ventral hernia, and performed laparoscopic hernia repair via a transabdominal preperitoneal (TAPP) approach. Patient #2 was a 91-year-old female who presented with left lower abdominal pain. Abdominal ultrasonography and CT showed a defect in the abdominal wall in the lateral aspect of the left rectal abdominal muscle with bowel prolapse. We diagnosed the patient as having a ventral hernia, and performed laparoscopic hernia repair using the intraperitoneal onlay mesh (IPOM) technique. Patient #3 was a 68-year-old man who presented with a right lower abdominal bulge. Abdominal CT showed a thin abdominal wall at the lateral edge of the right rectus muscle. We diagnosed the patient as having a Spigelian hernia, and performed preperitoneal repair via the anterior approach. Spigelian hernia is a rare disease, and a number of surgical procedures have been reported for its treatment. Recently, the tension-free repair method was reported to have several advantages, and a laparoscopic approach could add more from the viewpoint of diagnosis and treatment.