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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Preperitoneal mesh repair in Spigelian hernia
Wolfgang G Mouton1, Kim T Otten, Daniel Weiss
1Department of Surgery, Spital Thun-Simmental AG, 3600 Thun, Switzerland. wolfgang.mouton@spitalthun.ch
Abstract:
The first Spigelian hernia was described in 1764. From April 1995 to April 2004, 29 patients underwent 35 Spigelian hernia repair operations in our department. The choice of primary closure or additional mesh was based on the condition of the local tissue. If the tissue appeared of good quality, primary closure was performed; if the tissue was of weak quality, an additional nonresorbable mesh was implanted to induce a stronger scar tissue. Twenty-one Spigelian hernias were repaired using the primary closure method. There were three radiological recurrences, one of which was symptomatic after 10 months and required reoperation. In 14 cases, an additional preperitoneal mesh was implanted. There was no radiological or clinical recurrence in this group. Spigelian hernia repair may therefore have a lower recurrence rate if a preperitoneal mesh is initially implanted.
Insights
Spigelian hernia repair outcomes differ based on technique. Implantation of a preperitoneal mesh during Spigelian hernia repair surgery may lead to a lower recurrence rate compared to primary closure alone.
Area of Science:
- Surgery
- Gastroenterology
- Abdominal Wall Surgery
Background:
- Spigelian hernias, first described in 1764, are uncommon abdominal wall defects.
- Surgical repair techniques vary, influencing recurrence rates.
Purpose of the Study:
- To compare the recurrence rates of Spigelian hernia repairs using primary closure versus mesh implantation.
- To evaluate the impact of tissue quality on repair outcomes.
Main Methods:
- A retrospective review of 35 Spigelian hernia repairs performed between April 1995 and April 2004.
- Surgical techniques included primary tissue closure or implantation of a non-absorbable preperitoneal mesh.
- Repair method selection was based on local tissue quality.
Main Results:
- Twenty-one hernias were repaired with primary closure, resulting in three radiological recurrences (one symptomatic).
- Fourteen hernias had a preperitoneal mesh implanted, with no radiological or clinical recurrences observed.
- Mesh implantation was associated with a zero recurrence rate in this cohort.
Conclusions:
- Spigelian hernia repair with preperitoneal mesh implantation demonstrates a lower recurrence rate.
- The use of mesh may be beneficial for Spigelian hernia repair, particularly in cases with compromised tissue quality.
