A case of left superior lumbar hernia repaired using the mesh-plug method

Abstract

An 85-year-old woman was admitted to the hospital due to low back pain and a mass located at the left lumbar area. The mass was about 8×8 cm in diameter and had a soft elastic consistency. On physical examination, the hernia orifice was found at the left superior lumbar triangle. Computed tomography (CT) showed a defect of the abdominal wall between the left obliquus abdominis internus muscle and the erector muscle of the spine. The descending colon prolapsed to the extraperitoneal fat layer through a left lumbar muscle defect. Given the diagnosis of a left superior lumbar hernia, a herniorrhaphy was performed. The operative repair was done by inserting a Mesh-Plug into the fascial defect and covering the superior lumbar triangle with an onlay patch of a Marlex Mesh. The patient's postoperative course was uneventful ; no recurrence has been observed. A lumbar hernia is rare. It is primarily treated surgically. A hernia repair using the Mesh-Plug method, which was performed in this case, is well known in inguinal hernia surgery. This method is very simple and has few postoperative complications. As shown by this case it is also useful for herniorrhaphy of a lumbar hernia.