Laparoscopic preperitoneal repair of lateral hernia - our experience

Abstract

Aim: Lateral hernias are quite uncommon as compared to other ventral abdominal hernias. This study aims to show the feasibility and technical details of laparoscopic preperitoneal repair of lateral hernia.

Methods: This was a retrospective study performed from April 2016 to March 2024 involving patients with lateral hernia who underwent laparoscopic preperitoneal repair. The data regarding patient demographics, operative details, outcomes and follow-up were analyzed.

Results: A total of 57 patients who underwent laparoscopic preperitoneal repair for lateral hernia were identified. The mean age was 57.4 years (range 35-74), with a male preponderance in the ratio of 1.28:1 (males-32:females-25) and body mass index of 28.7 kg/m² (range 22.3-34.8). Most of the hernias were of postsurgical etiology (53, 92.9%), while the remaining were post-traumatic (4, 7.0%). No recurrent hernias were observed. The mean hernia defect width was 6.8 cm (range 3-12). The mean operative time was 178 min (range 145-242). There was no conversion to open. There have been no major complications noted. The mean hospital stay was 2.64 days (range 1-4). No recurrences have been reported in 24 months.

Conclusion: Lateral hernia is a rare entity. Based on our experience, the laparoscopic preperitoneal approach is a safe, feasible and effective choice for lateral hernia repair.

Keywords

Lateral hernia / flank hernia / lumbar hernia / iliac hernia / laparoscopy / preperitoneal repair

References

[1] Zhou DJ.Incidence, etiology, management, and outcomes of flank hernia: review of published data.Hernia2018;22:353-61

[2] Katkhouda N,Pham V.Management of lateral abdominal hernias.Hernia2020;24:353-8

[3] Muysoms FE,Berrevoet F.Classification of primary and incisional abdominal wall hernias.Hernia2009;13:407-14 PMCID:PMC2719726

[4] Shen C,Zhang S.Clinical, surgical characteristics and long-term outcomes of lumbar hernia.BMC Surg2021;21:332 PMCID:PMC8394050

[5] Gawhale SK,G S PK.Incisional hernia secondary to iliac crest bone graft: a rare case report and review of literature.J Orthop Case Rep2020;10:15-7

[6] Tsouknidas I,Antonopoulou MI,Manatakis DK.Traumatic lumbar hernia: a systematic review of the literature.Chin J Traumatol2024;27:53-7 PMCID:PMC10859291

[7] Kranz J,Wußow F,Anheuser P.Permanent flank bulge after flank incision: patient- and physician-reported outcome.Urol Int2022;106:387-96

[8] Lourié DJ.Lumbar hernias. In: Docimo S, Blatnik JA, Pauli EM, Editors. Fundamentals of hernia radiology. Cham: Springer International Publishing; 2023. pp. 237-45.

[9] Beffa LR,Carbonell AM.Flank and lumbar hernia repair.Surg Clin North Am2018;98:593-605

[10] Palanivelu C,John SJ,Senthilkumar K.Laparoscopic transperitoneal repair of lumbar incisional hernias: a combined suture and ‘double-mesh’ technique.Hernia2008;12:27-31

[11] Sanders DL,Simons MP.Midline incisional hernia guidelines: the European Hernia Society.Br J Surg2023;110:1732-68 PMCID:PMC10638550

[12] Pereira C.Open versus laparoscopic ventral hernia repair: a randomized clinical trial.Cureus2021;13:e20490 PMCID:PMC8684829

[13] Wijerathne S,Usmani F.Minimally invasive repair for lateral ventral hernia: tailored approach from a hernia centre at a tertiary care institution.Hernia2021;25:399-410

[14] See C, Kim T, Zhu D. Hernia mesh and hernia repair: a review.Eng Regen2020;1:19-33

[15] Li B,Yu J.Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results.Hernia2021;25:523-33

[16] Cavalli M,Morlacchi A.An extraperitoneal approach for complex flank, iliac, and lumbar hernia.Hernia2021;25:535-44

[17] Asencio F,Ferri R.Laparoscopic versus open incisional hernia repair: long-term follow-up results of a randomized clinical trial.World J Surg2021;45:2734-41