Laparoscopic mesh repair of a labial hernia

To present a narrated video designed to demonstrate the steps involved in a laparoscopic mesh repair of a labial hernia.

This was in a 76-year-old woman who presented with a small bowel hernia in to her left labium majus. In 2014 she had a robotically assisted radical cystectomy for bladder cancer with anterior exenteration. She developed the hernia in February 2015 and initially a vaginal approach was attempted to repair the hernia (with layered non-absorbable sutures to close the fascia over the defect) at her local hospital, although this was unsuccessful. A laparoscopic repair with mesh on the 10 May 2016 was undertaken at our unit.

This was a complex case requiring a multi disciplinary approach and individualised care. The need for a mesh was obvious: however, the use of both synthetic and biological meshes to achieve an optimum result was unique and highly successful.

In this instance a minimally invasive laparoscopic approach where initial adhesiolysis was performed and then a synthetic mesh sandwiched in between two biological porcine meshes provided a unique management solution. The patient was seen 8 weeks post operatively and at 14 months after the procedure. She had complete resolution of her symptoms with no residual hernia.