Abstract
A 73-year-old woman was admitted to our hospital complaining of an upper abdominal bulge. She underwent cardiac coronary bypass graft and aortic valve replacement in the previous year (2012). At that time, she had undergone median sternotomy and partial incision of the linia alba of the upper abdomen. Abdominal computed tomography showed disappearance of the linea alba and a bulge of adipose tissue prolapsed through fascial plane. We diagnosed the case as subxiphoid incisional hernia (SIH) and applied laparoscopic approach with ordinary technique using mesh. The patient's postoperative course was uneventful. Postoperative pain was controlled with NSAIDs. The patient was discharged on 7th postoperative day.
The merits of the approach are to minimize the size of wound, to provide less pain and to shorten the length of hospital stay. Due to the special anatomic structure of the subxiphoid region (sternum, ribs and diaphragm), the laparoscopic approach has minimal disadvantage because it allows us to observe the hernia orifice from the abdominal cavity. We conclude that laparoscopic repair of subxiphoid incisional hernia may have advantages in techniques and results.
