A 70-year-old woman was admitted to the hospital because of a mass at the left lumbar area. Physical examination showed an elastic soft mass 10cm in diameter at the left lumbar area. Ultrasonography and computed tomography offered a diagnosis of superior lumbar hernia. At operation a well defined 2.5cm defect in the transversalis fascia, which forms the floor of the superior lumbar triangle, was found and fat tissue surrounding the kidney prolapsed from this defect. Operative repair was done by inserting a mesh-plug into the fascial defect and covering the superior lumar triangle with onlay patch of a Marlex Mesh. The postoperative course was uneventful and she han been followed for 4 months without evidence of recurrence.
Twenty-one cases including ours have been reported in the Japanese literature so far. Of these 21 cases, a mean age was 72 and the male-to-female ratio was 8:13. Lesions were located on the left side in 13 cases, on the right side in six cases, and on the both sides in two cases. No cases applicated mesh-plug method with tension-free herniorrhaphy have been repoprted as far as we could review. We would emphasize the usefulness of this procedure for superior lumbar hernia.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)