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Published on: September 11, 2021
A traumatic abdominal wall hernia repair: a laparoscopic approach
Kenneth L Wilson1, Mustafa K Davis, James C Rosser
1Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|March 13, 2013
Summary
Traumatic abdominal wall hernias from blunt trauma are rare but can be missed. Laparoscopic repair offers a safe and effective solution for these complex injuries, even near the iliac crest.
Area of Science:
- Trauma surgery
- Minimally invasive surgery
- Abdominal wall reconstruction
Background:
- Traumatic abdominal wall hernias (TAWHs) are rare injuries resulting from severe blunt force, often in motor vehicle collisions.
- These hernias can be occult, with intact overlying skin masking the defect, complicating diagnosis.
- Traditional open repairs are challenging due to potential muscle avulsion from the iliac crest and bone loss.
Observation:
- A case of a 36-year-old female with a TAWH in the right flank following a high-impact motor vehicle collision is presented.
- Imaging (CT and MRI) revealed an abdominal wall defect not apparent on physical examination.
- The patient underwent successful laparoscopic repair of the traumatic abdominal wall hernia.
Findings:
- Laparoscopic approach facilitates clear delineation of the hernia defect.
- Tension-free mesh repair using a laparoscopic technique, similar to inguinal hernia repair, is effective for TAWH.
- One-year follow-up demonstrated no recurrence of the hernia.
Implications:
- TAWH should be suspected in patients with high-energy blunt abdominal trauma, especially motor vehicle collisions.
- Laparoscopic repair is a viable and successful option for TAWH, even with challenges like fixation to the iliac crest.
- This approach allows for safe and effective management of complex traumatic abdominal wall defects.
