Patle Nirmal M, Tantia Om, Sasmal Prakash K, Khanna Shashi, Sen Bimalendu
Department of Minimal Access Surgery, ILS Hospital, Kolkata, India.
J Laparoendosc Adv Surg Tech A. 2010 Mar;20(2):129-33. doi: 10.1089/lap.2009.0314.
Spigelian hernias are rare abdominal wall hernias occurring through a defect in the spigelian fascia lateral to the semilunar lines and pose great difficulty in diagnosis due to their location and varied presentations. The treatment of spigelian hernia has evolved from open surgical repair to laparoscopic hernioplasty. In this article, we share our experience of 6 patients with spigelian hernia managed by laparoscopic mesh repair and review the related literature on the topic.
A retrospective data collection of patients of spigelian hernia operated on between January 2005 and December 2008 was done. The data were evaluated regarding patient presentation, age group, methods of surgical repair, and the outcome of the procedures. The patients had follow-up at 1 week, 6 months, 1 year, and 2 years after the surgery and were evaluated for any recurrence or mesh-related complications.
In total, 6 patients of spigelian hernia were operated on in 4 years, from January 2005 to December 2008, with most of them presenting with either a lump or pain. All patients were operated by the transabdominal preperitoneal (TAPP) method with satisfactory results. No recurrences were found in 2 years of follow-up.
Laparoscopic TAPP is an acceptable method of spigelian hernia repair with good results and low recurrence rates. However, long-term follow-up studies are required to assess the late recurrence rate.
半月线外侧的耻骨肌孔筋膜缺损可导致半月线疝,这是一种罕见的腹壁疝。由于其位置和表现多样,半月线疝的诊断存在很大困难。半月线疝的治疗已从开放手术修补发展到腹腔镜疝修补术。在本文中,我们分享了6例接受腹腔镜补片修补术治疗半月线疝患者的经验,并回顾了该主题的相关文献。
对2005年1月至2008年12月间接受手术治疗的半月线疝患者进行回顾性数据收集。对患者的表现、年龄组、手术修复方法和手术结果进行了评估。患者在术后1周、6个月、1年和2年进行随访,评估有无复发或补片相关并发症。
2005年1月至2008年的4年间,共对6例半月线疝患者进行了手术,其中大多数患者表现为肿块或疼痛。所有患者均采用经腹腹膜前(TAPP)方法进行手术,效果满意。随访2年未发现复发。
腹腔镜TAPP是一种可接受的半月线疝修补方法,效果良好,复发率低。然而,需要长期随访研究来评估晚期复发率。