Repair of large diffuse lumbar hernias by an extraperitoneal binder technique

Lumbar hernias may be classified into two broad groups. The small protrusions of fat which appear in the superior or inferior lumbar triangles and large diffuse hernias which involve the entire flank. The small hernias are easily cured by simple closure of the defect similar to the treatment of small epigastric hernias. The surgical treatment of large lumbar protrusions, utilizing fascial and prosthetic onlay grafts, is ineffective. The new technique described, which employs a large sheet of polypropylene mesh as a binder in the extraperitoneal space, effectively bridges the large defect and provides firm support for the lumbar region.