Sandwiching a Lumbar Hernia: A Case Report

A lumbar hernia is characterized by the protrusion of intra-abdominal contents through a defect in the muscles of the lumbar region. They can be classified as primary or secondary based on their etiology. We present a case of a 65-year-old male who had swelling in the right flank region for nearly 20 years and experienced sudden onset pain over the last 20 days. He was diagnosed with a primary lumbar hernia in the inferior triangle, which was confirmed by computed tomography. Open onlay mesh repair was performed using a recently developed technique known as the sandwich technique. In this method, the muscle and defect are sandwiched between two polypropylene meshes to improve tensile strength and provide support, preventing future recurrence. The patient was followed up at one week, one month, and six months post-procedure, with no recurrence or complications observed. This case report highlights a rare type of primary lumbar hernia and emphasizes the successful outcome of this novel repair technique.