Premium
Long‐term results of laparoscopic treatment of Spigelian hernias with mesh
Author(s) -
Portillo G,
Franklin ME
Publication year - 2010
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2010.00040.x
Subject(s) - medicine , spigelian hernia , surgery , blood loss , hernia , laparoscopy , fixation (population genetics) , population , environmental health
Spigelian hernias are exceptional. They often present with vague signs and symptoms, and the diagnosis can be problematic. Most Spigelian hernias are treated with open surgery and without mesh; little is known of the laparoscopic treatment and the long‐term follow‐up with mesh. The aim of this study was to prospectively evaluate the safety and effectiveness of the laparoscopic treatment of Spigelian hernias with mesh at the Texas Endosurgery Institute. Methods: From February 1991 through April 2008, all Spigelian hernias treated laparoscopically with mesh were prospectively followed. The technique was essentially the same for each procedure and involved (1) lysis of adhesions, (2) reduction of hernia contents, (3) closure of the defect, (4) 3–5 cm circumferential mesh coverage beyond the original edges, and (5) transfascial fixation of the mesh. Results: Eighteen patients were analyzed, all of them having Spigelian hernia. The subjects included eight women (44%) and 10 men (56%), with a mean age of 65 years (range, 39–89 years). The mean height of patients was 1.69 cm (range, 1.44–1.98 cm), with a mean weight of 84.6 kg (range, 63–103.5 kg). The mean operative time was 91 min with a range of 75–120 min. The estimated blood loss was 30 ml (range 10–50 ml). The mean postoperative hospital stay was 2 d (range from same‐day discharge to 5 d). The overall postoperative complication rate was 16.6%. No conversions to open approach were required. The mean follow up was 84.6 months (range, 13–176 months); no recurrence has been observed. Conclusion: The laparoscopic treatment of Spigelian hernias is safe and effective.