Abstract
A 60-year-old man was hospitalized because of a soft mass in the right lower abdominal area. The mass was 3cm in size. Abdominal computed tomography showed prolapsed fat tissue in the right lower abdominal wall. Spigelian hernia or inguinal hernia was suspected. At operation, the hernia orifice was identified beneath the aponeurosis of the external oblique muscles as a slit in the internal oblique muscle. The hernia sac, prolapsed from the orifice, was about 2.5cm in diameter. We diagnosed a Spigelian hernia. A mesh-plug was inserted into the orifice and an onlay patch was fixed to the superior internal oblique muscle.
The postoperative course was uneventful and he was discharged on the 3rd postoperative day. He has been followed for 4 months to date, without recurrence.
Spigelian hernias are very rare. Hernia repair using the mesh-plug method is advantageous because it allows tension-free repair without complications.
