Perineal hernia repair with a combined abdominoperineal approach with biologic mesh placement and peritoneal flap reconstruction.

Perineal hernias occur rarely following abdominoperineal resections. No standardized surgical approach exists for treating PH. We herein present the case of a large, symptomatic PH that was repaired with a combined abdominal and perineal approach, with peritoneal flap reconstruction of the pelvic floor and placement of a biological mesh. The patient has not recurred after 3 years of follow-up. In conclusion, despite the lack of a standardized approach for tackling perineal hernias, a combined one with peritoneal flap reconstruction can be successfully used.