Journal of Minimal Access Surgery

REVIEW ARTICLE
[View FULLTEXT] [Download PDF]
Year : 2008  |  Volume : 4  |  Issue : 4  |  Page : 95--98

Diagnosis and management of Spigelian hernia: A review of literature and our experience

T Mittal, V Kumar, R Khullar, A Sharma, V Soni, M Baijal, PK Chowbey 
 Minimal Access and Bariatric Surgery Centre, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi - 110 060, India

Correspondence Address:
A Sharma
Room No. 200, Minimal Access and Bariatric Surgery Centre, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi - 110 060
India

Spigelian hernia occurs through slit like defect in the anterior abdominal wall adjacent to the semilunar line. Most of spigelian hernias occur in the lower abdomen where the posterior sheath is deficient. The hernia ring is a well-defined defect in the transverses aponeurosis. The hernial sac, surrounded by extraperitoneal fatty tissue, is often interparietal passing through the transversus and the internal oblique aponeuroses and then spreading out beneath the intact aponeurosis of the external oblique. Spigelian hernia is in itself very rare and more over it is difficult to diagnose clinically. It has been estimated that it constitutes 0.12% of abdominal wall hernias. The spigelian hernia has been repaired by both conventional and laparoscopic approach. Laparoscopic management of spigelian hernia is well established. Most of the authors have managed it by transperitoneal approach either by placing the mesh in intraperitoneal position or by raising the peritoneal flap and placing the mesh in extraperitoneal space. There have also been case reports of management of spigelian hernia by total extraperitoneal approach. We retrospectively reviewed our experience of ten patients between 1997 and 2007. Eight patients (8/10) presented with abdominal pain and two patients (2/10) were asymptomatic. In six patients (6/10) we performed an intraperitoneal onlay IPOM repair, in two patients (2/10) transabdominal preperitoneal repair (TAPP), and in two (2/10) total extraperitoneal repair (TEP). There were no recurrences, or other morbidity at mean follow up period of 3.2 years (range 6 months to 10 years).


How to cite this article:
Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M, Chowbey P K. Diagnosis and management of Spigelian hernia: A review of literature and our experience.J Min Access Surg 2008;4:95-98


How to cite this URL:
Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M, Chowbey P K. Diagnosis and management of Spigelian hernia: A review of literature and our experience. J Min Access Surg [serial online] 2008 [cited 2020 Aug 3 ];4:95-98
Available from: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2008;volume=4;issue=4;spage=95;epage=98;aulast=Mittal;type=0