Spigel hernia: a single center experience in a rare hernia entity

Spigelian Hernia (SH) is a rare ventral hernia with a high incarceration and obstruction risk. The purpose of this study is to present our experience in diagnosis and treatment of this rare hernia entity.

Sixteen patients underwent surgery for SH between 2000 and 2010. Analysis parameters included demographic data, location of defect, diagnostic methods, mode of surgery, mode of anesthesia and postoperative outcome.

Mean follow-up was 98 months. The gender bias was 37.5 %: 62.5 % (man: woman) with mean age of 56 years. The SH was right-sided in 56.25 %, left-sided in 37.5 % and bilateral in 6.25 % of the cases. The preoperative diagnosis was correct in 25 % of the cases. Eight patients (50 %) underwent elective surgery, and the other 8 patients (50 %) underwent surgical treatment on emergency basis. Two patients underwent open hernia repair by primary suture, 13 patients underwent open mesh repair and one patient underwent a laparoscopic mesh repair. Neither a major hernia repair-related complication nor mortality could be registered.

SH is a rare entity with a wide clinical spectrum and difficulties in preoperative diagnosis. Once the diagnosis of SH is established, a surgical treatment is indicated because of the high complication risk.