Robotic repair of a traumatic Spigelian hernia

Spigelian hernias are a rare type of hernia that can be either congenital or acquired from weakening of the semilunaris line. Spigelian hernias are often difficult to diagnose due to the lack of an obvious defect on physical exam. This report presents the case of a traumatic Spigelian hernia in a 59-year-old after a fall from a tree onto a fence. Computed tomography imaging demonstrated several rib fractures as well as an 8 cm fat-containing Spigelian hernia. Given the risk of bowel herniation, this was repaired during the same admission via a robot-assisted approach with primary repair of the defect and mesh placement in an intraperitoneal onlay mesh fashion. At the patient's postoperative visits at 1, 3, and 8 months, there was no evidence of hernia recurrence. This case highlights the robotic intraperitoneal onlay mesh technique as a safe and durable option for the repair of traumatic Spigelian hernias.