Laparoscopic hernioplasty in secondary lumbar hernias

Lumbar hernia is an uncommon defect of the posterior abdominal wall, and surgical treatment is still controversial. The aim of this study was to analyze the utility of the laparoscopic approach in the repair of these hernias.

We undertook a descriptive analysis of 15 patients diagnosed with lumbar hernia who underwent surgery with transabdominal laparoscopy between 1997 and 2004. The following variables were analyzed: clinical data, intraoperative and postoperative complications, operative time, length of hospital stay, analgesic consumption, and recurrences. The technique was evaluated aesthetically by measuring the abdominal perimeter using a tape measure. The mean follow-up was 32 months (range, 12-55 months).

Intraoperative morbidity consisted of two cases of bleeding caused by the mechanical suture. Postoperative morbidity consisted of 3 cases of hematomas, 2 of seromas, and 2 of transitory pain. Seven patients (47%) were treated as day cases, and only one required admission due to pain. At 12-month follow-up we found one recurrence and a significant reduction in abdominal perimeter (P < 0.05).

The transabdominal laparoscopic approach offers good clinical and aesthetic results both for the patient and the hospital, as almost half of the cases can be treated as day cases. We believe it should be considered the technique of choice for incisional lumbar hernia repair.