As regards to postoperative morbidity literature describes minimal and mild complications such as wound infections, paralytic ileus or haematomas. Rev Esp Enferm Dig ; Mesh-free epgastrica spigelian hernia repair. Minerva Chir ; Clinical diagnosis does require a high index of suspicion. Pain often can be provoked or aggravated by contraction of abdominal muscles or other maneuvers that increase the intra abdominal pressure 7and this can help us orienting the correct diagnosis.
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Shashicage The treatment of Spigelian hernia should be surgical. The gold standard is TC in doubtful cases. We do not completely agree with this opinion as we tscnica a prosthetic material should not be implanted at the same time that any other surgical procedure with risk of contamination. After this report only isolated cases, congenital SH associated with cryptorchidism or the Satorras-Fioretti review about abdominal wall hernias of unusual presentation which included 12 patients with Spigelian hernia 6 have been published.
We present the results of our own series and a literature review. Minerva Chir ; However it could be difficult to identify them during the physical examination as the hernia sac is located beneath the aponeurosis of the external oblique.
An important percentage of patients will present with an acute complication of the Spigelian hernia as their first symptom. The different options include primary closure or mesh repair in cases of atrophic aponeurosis, wide defect or recurrences.
Laparoscopic repair of spigelian hernia: Apart from the type of surgical approach exists discussion about the need of a prosthetic mesh. A high index of suspicion and a thorough physical examination is needed to make a correct diagnosis, although in doubtful cases it is advisable to perform a sonography or better a tomography.
It is also called spontaneous lateral ventral hernia, hernia of semilunar line, hernia of the conjoint tendon or interstitial ventral hernia. J R Coll Surg Edinb ; Spigelian quiturgica have a multidisciplinary interest and their diagnosis involves various specialities such us surgeons, radiologists and in some instances internists and gastroenterologists when the SP presents as abdominal pain syndromes. There was a problem providing the content you requested Epigastruca first one allows to explore the contralateral side as well as the abdominal cavity and for some authors is the recommended method when there is another process requiring associated surgery because can be performed in the same intervention 6.
Modality of laparoscopic treatment is still on discussion. In addition to previous or concomitant hernias as a hernai factor we have also looked for other medical conditions such as COPD or prior abdominal surgery. Ugeskr Laeger ; Personal experience and review of the literature Hernias de Spiegel. InCarter y Mizes performed the first intra-abdominal laparoscopic correction 20 and inSalvador et al published the first one in Spain An analysis of cases. It occurs because of a weak area of spiegelian fascia which is localized between the semilunar line and the lateral edge of the anterior rectus muscle.
When the hernia sac contents the bowel the patient can present with nausea, vomiting or altered bowel rhythm. Clinical diagnosis does require a high index of herniw. In two patients a bowel resection was needed because of incarceration although the hernia sac content found was usually preperitoneal fat or omentum.
The eigastrica modality of endoscopic treatment is the extraperitoneal approach that offers the advantage of avoiding general anesthesia so that can be performed easily as an outpatient procedure and also avoids the possible added risk of visceral lesions as demonstrates the only prospective randomized controlled trial comparing conventional versus laparoscopic management of Spigelian hernia Vos D, Scheltinga M.
There was neither serious morbidity nor mortality. Epidemiological aspects, diagnostic methods, surgical technique characteristics, morbidity, hospital stay, recurrences and follow up are analyzed. Generally speaking, laparoscopic approach results in less infection rate, quicker incorporation to activities dpigastrica daily living, less postoperative pain and specially avoids opening the external oblique aponeurosis and therefore a risk reduction of recurrence 1. Br J Surg ; The symptoms can vary quirutgica are non specific.
We present our series of patients with Spigelian hernia and a literature review. J Minim Access Surg ; 4 4: Left side was the most frequent location. Laparoscopic diagnosis and repair of spigelian hernia: To date Spanish reports on this pathology are short series of cases, being the largest one published by Moreno-Egea et al in with 27 patients 5.
Most of these hernias occur distal to the umbilicus, within the spigelian hernia belt or Spangen area which is a transverse band between the line joining both anterior superior iliac spines and a parallel line 6 cm cranial at the level of the umbilicus 1,2. Personal experience and review of the literature.
Mesh-free laparoscopic spigelian hernia repair. The mean age was 70 years range years. Twenty five patients Related Articles
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