Spigelian hernia and cryptorchidism syndrome: open spigelian hernia repair and laparoscopic one-stage orchiopexy for...

Spigelian hernia and cryptorchidism syndrome in children is increasingly reported in the literature. A variety of phenotypes have been reported, so diagnostic approaches and operative techniques remain poorly defined. The case of an infant male who presented with a left spigelian hernia and ipsilateral cryptorchidism who was initially misdiagnosed with an ectopic inguinal testis is presented. He underwent diagnostic laparoscopy which revealed an ectopic left testis within the spigelian hernia defect with a gubernaculum present. Collaborative decision making between paediatric surgery and paediatric urology resulted in the final operative repair entailing laparoscopic orchiopexy, open left spigelian and inguinal hernia repair, right inguinal hernia repair and umbilical hernia repair. We conclude that a laparoscopic orchiopexy of an ectopic testis within a spigelian hernia is a safe method to address this rare phenomenon, but collaborative multidisciplinary discussion is ideal to weigh operative strategies and management.