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This article explores the impact of incisional hernias on abdominal wall strength. It highlights that incisional hernias, which commonly occur after abdominal surgeries, can lead to complications and a decrease in quality of life for patients. The study focuses on analyzing abdominal muscle strength in patients with incisional hernias compared to healthy individuals. The results indicate significant differences in abdominal muscle strength between the two groups, suggesting that incisional hernias can have a negative effect on abdominal wall strength. The study also identifies factors such as sex, hernia size, and BMI as influential factors in abdominal strength. It suggests that identifying reduced abdominal strength in individuals with hernias could improve their overall quality of life and inform perioperative management. The study proposes the use of a strain gauge as a cost-effective alternative for assessing abdominal muscle strength. However, it is important to note that the study has limitations, such as not considering baseline physical activity levels and back pain. This information can be valuable for individuals researching the effects of incisional hernias on overall health and quality of life. [Extracted from the article]

Abdominal wall hernia repair, a common surgical procedure, includes various techniques to minimize postoperative complications and enhance outcomes. This review focuses on the comparison between laparoscopic and robotic approaches in treating inguinal and ventral hernias, presenting the ongoing situation of this topic. A systematic search identified relevant studies comparing laparoscopic and robotic approaches for inguinal and ventral hernias. Randomized control trials, retrospective, and prospective studies published after 1 January 2000, were included. Search terms such as hernia, inguinal, ventral, laparoscopy, robotic, and surgery were used. A total of 23 articles were included for analysis. Results indicated similar short-term outcomes for robotic and laparoscopic techniques in inguinal hernia repair, with robotic groups experiencing less postoperative pain. However, longer operative times and higher costs were associated with robotic repair. Robotic ventral hernia repair demonstrated potential benefits, including shorter hospital stay, lower recurrence and lower reoperation rates. While robotic surgery offers advantages such as shorter hospital stays, faster recovery, and less postoperative pain, challenges including costs and training requirements need consideration. The choice between laparoscopic and robotic approaches for abdominal wall hernias should be tailored based on individual surgeon expertise and resource availability, emphasizing a balanced evaluation of benefits and challenges. [ABSTRACT FROM AUTHOR]

Lumbar incisional hernia is an uncommon complication that affects the abdominal wall integrity, accounting for approximately 3.5% of all cases. It typically occurs following open nephrectomy or aortic aneurysm repair surgeries. Although rare, lumbar hernias can lead to discomfort, aesthetic issues, or even intestinal obstruction. In extremely rare cases, lumbar herniation of the liver can occur. Here, the authors present a case of a 60-year-old female patient with liver herniation through a lumbar incisional hernia and a history of pyelolithotomy for renal calculi. The authors performed an open hernia repair with meshplasty. Lumbar incisional hernias are rare and still difficult to manage. Computed tomography is the diagnostic method of choice in the evaluation of the parietal wall defect to choose the appropriate therapeutic management. Surgical management modalities are still poorly codified, with no precise recommendations, and this is probably due to the relative rarity of the cases. [ABSTRACT FROM AUTHOR]

Introduction: Spiegel-Casseri’s hernia (HSC) is an infrequent entity that represents about 2 % of abdominal wall herniary defects, but frequency could be increased due to its subdiagnosis. The diagnosis of HSC is usually diffi cult and unsuspected and it presents high risk of jamming and strangulation so its surgical management is imperative. A TC is essential for diagnosis. Case report: Male, with pathological antecedents of myasthenia gravis, who consults about bilateral inguinal hernia and left Spiegel-Casseri’s hernia. Due to his clinical history, an open preperitoneal surgical approach with Lichtenstein plastic to repair all the three defects is done. During the postoperative, he had a bruise on the dropped hernial sac, treated with conservative measures and control and didn’t require drainage. Discussion: Most series of notifi ed cases of HSC in the literature show variable incidence of attendant abdominal wall’s defects. In this case, myasthenia gravis, a chronic and weakening disease, prompted three associated parietal defects and limited anesthesiologist options and surgical approaches. HSC is an unusual entity and its association with others hernias even more, but it exists and must be taken into account to achieve an optimal treatment for the patient. [ABSTRACT FROM AUTHOR]

Background: Groin hernia repair is one of the most common operations performed globally, with more than 20 million procedures per year. The last guidelines on groin hernia management were published in 2018 by the HerniaSurge Group. The aim of this project was to assess new evidence and update the guidelines. The guideline is intended for general and abdominal wall surgeons treating adult patients with groin hernias. Method: A working group of 30 international groin hernia experts and all involved stakeholders was formed and examined all new literature on groin hernia management, available until April 2022. Articles were screened for eligibility and assessed according to GRADE methodologies. New evidence was included, and chapters were rewritten. Statements and recommendations were updated or newly formulated as necessary. Results: Ten chapters of the original HerniaSurge inguinal hernia guidelines were updated. In total, 39 new statements and 32 recommendations were formulated (16 strong recommendations). A modified Delphi method was used to reach consensus on all statements and recommendations among the groin hernia experts and at the European Hernia Society meeting in Manchester on October 21, 2022. Conclusion: The HerniaSurge Collaboration has updated the international guidelines for groin hernia management. The updated guidelines provide an overview of the best available evidence on groin hernia management and include evidence-based statements and recommendations for daily practice. Future guideline development will change according to emerging guideline methodology. [ABSTRACT FROM AUTHOR]

The most prevalent type of abdominal wall hernias are inguinal. Although the prevalence of inguinal hernias is unknown, roughly 500,000 cases are treated in hospitals annually. There is a dearth of information on inguinal hernia primary and recurrence rates in our nation. to compare the age- and gender-specific prevalence rates of inguinal hernia. to estimate the prevalence of inguinal hernia among various age groups. According to the study, those between the ages of 41 and 50 (29.29%) are the most susceptible to developing an inguinal hernia. Eighty eight percent of the patients were men. The most frequent hernia among patients was on the right side. In the study population, heavy object lifting and chronic coughing were frequently identified as risk factors. Our findings may serve as a useful guide for future research on the frequency of inguinal hernias in general populations. [ABSTRACT FROM AUTHOR]

Interparietal inguinal hernia, an exceedingly rare type of inguinal hernia in which the hernia sac anatomically lies between the tissue layers of the abdominal wall, is difficult to diagnose from physical findings. Given the few reports on interparietal inguinal hernias, this condition has remained fairly unrecognized. Herein, we report the successful imaging and laparoscopic diagnoses as well as repair of an interparietal inguinal hernia. Atypical physical findings and computed tomography data help in the diagnosis of an interparietal inguinal hernia. The laparoscopic approach is useful and feasible for both the diagnosis and treatment of interparietal inguinal hernia. [ABSTRACT FROM AUTHOR]

Introduction: In the last decade, groin pain has become the main complication of hernioplasty and a major public health problem. This problem can only be controlled by ensuring adequate knowledge of lumbar neuroanatomy. The objective of this work is to review the history of inguinal neuroanatomy in relation to hernia pathology and the specialty of the abdominal wall. Method: Literature review of PubMed, LILACS, Cochrane Library databases; supplementary search using Google (Google Play), of university libraries. As keywords have been used: “lumbar plexus”, “inguinal nerves”, “ilioinguinal nerve”, “iliohipogastric nerve”, “genitocrural nerve”, “hernia”, “anatomy” and “surgery”. A critical analysis of published articles, theses, books and monographs is carried out. Manuscripts obtained from any country, by any institution or researcher and in any language, without time limit, are stored in pdf format. Results: The study of the history of the inguinal nerves with current methodology shows the succession of knowledge until reaching the current anatomical terminology and in parallel, the development of surgical techniques until neural pathology is considered of interest. Conclusions: Schmidt’s study offers us the most recognized descriptive topography with the first advice on clinical problems associated with neural injury during a hernia operation. His classification is the one adopted as official anatomical terminology. The concepts of the intramuscular plexus of the psoas and the iliac fossa anastomotic system were introduced by the Spaniard Gómez Durán (1923). A clear disconnection between the advances in hernia and neural anatomical-surgical knowledge is demonstrated, with a delay of two centuries in its topographical application to the abdominal wall specialty. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernia repair is a commonly performed general surgery procedure in both adults and children with inguinal hernias constituting more than 95% of all groin hernia repairs. The present study was conducted to assess risk factors of inguinal hernia. Materials & Methods: 94 cases of inguinal hernia of both genders were enrolled. Parameters such as the type of hernia, primary or recurrent was noted. Period of swelling, side and risk factors were recorded. Results: Out of 94 patients, males were 60 and females were 34. Side was right in 28, left in 30 and bilateral in 36. Type of hernia was primary in 54 and recurrent in 40. Period of swelling was <1 year in 32, 1-2 years in 40 and >2 years in 22. The difference was significant (P< 0.05). Common risk factors for inguinal hernia were COPD in 24, lifting heavy objectsin 88, alcoholism in 26, smoking in 34, diabetes in 30, family history in 11, bowel disturbances in 72 and age >60 yearsin 26. The difference was significant (P< 0.05). Conclusion: Common risk factors for inguinal hernia were COPD, lifting heavy objects, age >60 years, alcoholism, smoking, diabetes, family history and bowel disturbances. [ABSTRACT FROM AUTHOR]

Herniation of a gravid uterus through an abdominal wall incisional hernia with overlying skin necrosis is exceptionally rare. A 29-year-old multiparous K30 + 4/40 pregnant female presented with a 1-month history of worsening abdominal wall skin changes. Magnetic resonance imaging of the abdomen and pelvis confirmed herniation of the gravid uterus into the hernia sac. A lower uterine segment caesarean section and hernia repair were performed by the general surgical and obstetrics team in view of the potential maternofoetal complications. This case highlights the importance of early recognition and the difficulties in managing gravid uterus herniation. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: The term "sclerosing mesenteritis" includes a spectrum of rare idiopathic diseases involving the small and/or large bowel. It appears as a diffuse, localized, or multinodular thickening of the mesentery, with a variable degree of chronic non-specific inflammation, fat necrosis, and fibrosis. Case Report: Here, we report a case of 83-year-old woman with symptoms of intestinal occlusion, vomiting, and abdominal pain. Radiographic examinations showed air fluid levels in right and left quadrants and in the mesogastric site, while computed tomography (CT) documented a strangulated inguinal hernia with ileal obstruction. Based on clinical examination and radiologic findings, the patient underwent surgery for inguinal hernia reduction. The examination of viscera revealed 2 tracts of ileum with ischemic signs and covered by fibrin; thus, the 2 intestinal loops were resected. Histological examination revealed chronic non-specific inflammation of the whole intestinal wall, including the subserosa in the resected tract of proximal ileum, while the distal ileal loop (not herniated tract) showed a subserosal fibrous nodule of 2 cm in greatest diameter, composed of a proliferation of spindle cells haphazardly arranged in a collagenized stroma. The diagnosis of sclerosing mesenteritis was rendered. Conclusions: The present case shows the possibility of an incidental diagnosis during another intervention such as hernia surgery. Pathologists should be aware of this disease to avoid confusion with aggressive tumors such as intraabdominal desmoid-type fibromatosis and gastrointestinal stromal tumor. [ABSTRACT FROM AUTHOR]

Background/aim: Lumbar hernia is caused by a defect in the abdominal wall. Due to its rarity, there is no established consensus on optimal treatment for lumbar hernia yet. Thus, we here investigated the clinical, surgical characteristics and outcomes of lumbar hernia by collecting 28 such patients from our hospital.Methods: Patients diagnosed with lumbar hernia from our institution between April 2011 and August 2020 were retrospectively collected in this study. Demographics, clinical characteristics and surgical information were recorded.Results: A consecutive series of 28 patients with lumbar hernia were retrospectively collected, including 13 males (46%) and 15 females (54%). The ages of the patients ranged from 5 to 79 years (median: 55 years), with a mean age of 55.6 ± 14.9 years. A total of 7 cases had a history of previous lumbar trauma or surgery. There were 11 (39%), 15 (54%) and 2 (7.1%) cases had right, left and bilateral lumbar hernia, respectively. Superior and inferior lumbar hernia were found in 25 (89%) and 3 (11%) patients. General anesthesia was adopted in 16 cases (group A), whereas 12 patients received local anesthesia (group B). Patients in the group B had a shorter hospital stay than that of the group A (3.5 ± 1.3 days vs. 7.1 ± 3.2 days, p = 0.001), as well as total hospitalization expenses between the two groups (2989 ± 1269 dollars vs. 1299 ± 229 dollars, p < 0.001). With a median follow-up duration of 45.9 months (range: 1-113 months), only 1 (3%) lumbar hernias recurred for the entire cohort.Conclusions: Lumbar hernia is a relatively rare entity, and inferior lumbar hernia is rarer. It is feasible to repair lumbar hernia under local anesthesia. [ABSTRACT FROM AUTHOR]

Background: Obturator hernia is rare and accounts for less than 1% of all abdominal wall hernias. It represents a diagnostic challenge due to its nonspecific signs and symptoms.Case Presentation: We present a case of an 89-year-old caucasian female with a 12-hour history of right medial thigh pain. Computed tomography scan revealed a right obturator hernia with small bowel obstruction. The hernia was successfully repaired laparoscopically without any need for small bowel resection. She was discharged on postoperative day 2 with an uneventful recovery and zero complications.Conclusion: This case report highlights the importance of rapid diagnosis and repair of obturator hernia even in the setting of an improving clinical picture. It also demonstrates the safety of laparoscopic repair in this setting. [ABSTRACT FROM AUTHOR]

Purpose: To explore the value of medical three-dimensional visualization technology in precise preoperative assessment of complex abdominal wall defects. Methods: The clinical data of 30 patients were analyzed retrospectively from November 2017 to December 2020 in our department. Ten patients had abdominal wall hernias and 20 patients suffered from abdominal wall tumors. CT examination was performed, and data were stored in the form of DICOM. Three-dimensional reconstruction and related data analysis were performed by Medraw software, which can accurately show the calculation of the abdominal wall defect area, abdominal wall defect classification and zoning. Results: The ratio of the volume of the hernia sac to the whole abdominal volume in 10 patients with abdominal wall hernia was 4.75%. The average ratio of defect area to the whole abdominal wall in 16 patients suffered from abdominal wall tumors was 17.68%. Preoperative three-dimensional reconstruction can accurately obtain an average abdominal wall defect area of 227.83 ± 157.33 cm2 and accurate abdominal wall classification and zoning. Combined with clinical information, we can develop personalized surgical plans for patients. The average operating time was 5.39 ± 2.71 h, respectively, and the average hospital stay was 22.77 ± 11.59 days. The mean follow-up time was 21.09 ± 9.72 months. The incidence of postoperative complications was 23.33% (7/30). The recurrence rates of incisional hernias and abdominal wall tumors were 20.00% (2/10) and 15.00% (3/20), respectively. The patient survival rate was 86.67% (26/30). Conclusion: Three-dimensional visualization technology can be used for the accurate evaluation of patients with complex abdominal defects before surgery and can help surgeons design personalized surgical plans for patients. [ABSTRACT FROM AUTHOR]

Background: Hernia is an unusual bulging of the intra-abdominal viscera through a weak area of the abdominal wall or groin region. Inguinal hernia repair is one of the most frequently performed surgical procedures. In recent years, inguinal hernia (IH) repair was changed from pure tissue repair to prosthetic laparoscopic repair. Objective: we propose to find a new application for the well-known surgical open mesh inguinal hernia in the treatment of inguinal hernias in adults aiming to improve patients' comfort and to reduce the incidence of chronic neuralgia. Patients and Methods:. A comparative study was designed to study the outcome of different sizes of mesh used in the hernia operations. In the present study, patients diagnosed with primary unilateral inguinal hernia (n=130) were enrolled from May 2019 to March 2020 at Baquba teaching hospital in Diyala governorate. Enrolled patients were divided into two groups. Group A include patients who have inguinal hernia operated with all in one procedure (n=65) and group B included patients with inguinal hernia operated by the classical method (n=65). Spinal and general anaesthesia were used. Before incision for the patient, ceftriaxone (1gm, intravenously) was administrated over 30 min. The process was accomplished on a one-day surgery basis. According to the devised technique, a new smaller prosthesis was placed on the floor of the inguinal canal in order to strengthen all areas of weakness from which hernias may originate. The mesh was enveloped by a fibrocremasterico sheath avoiding contact with neural structures. Follow-up was carried out at 1week, 1month, 3months for evaluation of postoperative pain using numbering scale score, need of medication, patients' comfort, and postoperative complications. Results: all patients operated by all in one procedure were discharged within 24 h from surgery. Slight pain was reported by the majority of patients and (07.69%) of them required pain medication at home. After the 1st postoperative week (95.36%) reported no pain and (04.62%) show bruising genitaliao, (01.54%) had seroma and no wound infection recorded. No relevant limitation of normal activities was reported. There have been no postoperative neuralgias. Conclusion: This new hernioplastyo technique respects the anatomy of the inguinal canal, uses a smaller mesh, and seems to avoid neuralgias with maximum comfort for the patients. We recommended to all in one technique o because gives better results and fewer complications. [ABSTRACT FROM AUTHOR]

From the clinical point of view, a proper diagnosis of spigelian, inguinal and femoral hernias may be relevant for orienting the patient's management, as these conditions carry a different risk of complications and require specific approaches and treatments. Imaging may play a significant role in the diagnostic work-up of patients with suspected abdominal hernias, as the identification and categorization of these conditions is often unfeasible on clinical ground. Ultrasound imaging is particularly suited for this purpose, owing to its dynamic capabilities, high accuracy, low cost and wide availability. The main limitation of this technique consists of its intrinsic operator dependency, which tends to be higher in difficultto- scan areas such as the groin because of its intrinsic anatomic complexity. An in-depth knowledge of the anatomy of the lower abdominal wall is, therefore, an essential prerequisite to perform a targeted ultrasound examination and discriminate among different types of regional hernias. The aim of this review is to provide a detailed analysis of the fascial architecture and aponeurotic passageways of the abdominal wall through which spigelian, inguinal and femoral hernias extrude, by means of schematic drawings, ultrasound images and video clips. A reasoned landmark-based ultrasound scanning technique is described to allow a prompt and reliable identification of these pathologic conditions. [ABSTRACT FROM AUTHOR]

Lumbar hernias are rare abdominal wall defects. Fewer than 400 cases have been reported in the literature and account for 2% of all abdominal wall hernias. Lumbar hernias are divided into Grynfelt-Lesshaft or Petit hernias. The former are hernia defects through the superior lumbar triangle, while the latter are defects of the inferior lumbar triangle. Primary lumbar hernias are further subdivided into congenital or acquired hernias and can further be classified as either primary or secondary. Secondary hernias occur after previous flank surgeries, iatrogenic muscular disruption, infection, or trauma. We review a rare presentation of metachronous symptomatic bilateral secondary acquired lumbar hernia following spine surgery. A successful laparoscopic transabdominal lumbar hernia repair with extraperitoneal mesh placement was performed, with resolution of the hernia symptoms. An extensive literature review regarding lumbar hernia and different types of repairs was performed. [ABSTRACT FROM AUTHOR]

Internal hernias are an uncommon cause of small bowel obstruction and present a challenging clinical diagnostic scenario. They result from the abnormal protrusion of an abdominal organ through a peritoneal defect and can cause intermittent obstructive symptoms, diffuse abdominal discomfort, and postprandial pain. Paraduodenal hernias comprise 53% of all internal hernias 1 and occur due to failure of the fixation of either the left or transverse mesocolon to the posterior abdominal wall. Its relative rarity results in mortality between 20 and 50% 2 because of delayed diagnosis and consequent obstruction, strangulation, and bowel ischemia. Our case series describes three patients before and after operative fixation of paraduodenal hernia. Only one of the three was identified by preoperative radiologist interpretation. Subsequent diagnosis and definitive treatment were completed by surgical staff to resolve undiagnosed undulating abdominal pain and obstructive-type symptoms. We further analyze left-sided paraduodenal hernias after laparoscopic and robotic repair to define common symptomatology, typical CT findings, and preferred laparoscopic repair techniques. [ABSTRACT FROM AUTHOR]

In very few cases stated in the literature, the vermiform appendix might be contained in a hernial sac. This distinctive pathology is described as Amyand's hernia and has the very small occurrence of about 1%. We report the case of a 62-year-old man that presented for a reducible tumoral mass located in the right inguinal region. Amyand’s hernia was the intraoperative diagnostic. We performed hernioplasty (using the Lichtenstein tension-free mesh repair with a composite polypropylene mesh) without appendectomy. This case matches the type 1 Lossanoff and Basson’s classification and has no facile management. Due to the clinical specificities of each case that presents with defining features of an Amyand’s hernia, surgical management depends on the recommendations stated in the literature, as well as the surgeon’s judgment based on experience. [ABSTRACT FROM AUTHOR]

We present an extremely rare case of inguinal hernia coexisting with testicular ectopia in a child. Male infant 9.5 month old presented with an empty scrotum and the ipsilateral intravaginal testis lying in a high iliac crest position. When crying a moving right inguinal bulge appeared on clinical examination. This grew bigger in moments of increased abdominal pressure and seemed to move upwards towards the right ileac crest. No abdominal wall defect could be palpated. At operation a large hernia sac fixed in the area of the right iliac crest was identified. Adjacent was the fixation point of the gubernaculum and the testis was found in an ectopic location. We removed the large sac after separating the vas and vessels and the testis and we strengthened the dorsal inguinal wall and fixed the testis in a subdartos scrotal pouch. No postoperative complications happened. An undescended testis may present as an iliac crest ectopy, coexisting with moving inguinal hernia. In our case we propose that the higher position of the aponeurosis of the external oblique in combination with ectopia of gubernacular fixation in the ipsilateral scrotum may have caused the ectopic fixation of the sac in the ipsilateral inguinal crest. [ABSTRACT FROM AUTHOR]

Objective: Rare disease. Background: Spigelian hernia, or lateral ventral hernia, is rare and represents between 0.1-2% of all hernias of the abdominal wall. The presentation is variable, and the diagnosis may be challenging. This report is of an unusual case of Spigelian hernia that contained part of a fibroid uterus and the left adnexa. Case Report: A 66-year-old woman presented with an abdominal wall mass in the left lower quadrant. On physical examination, a provisional diagnosis of ventral hernia was made. Abdominal computed tomography (CT) imaging showed an unusual Spigelian hernia that contained part of a fibroid uterus and the left adnexa. Treatment using laparoscopic hysterectomy, left salpingo-oophorectomy, and hernia repair was successfully performed jointly by a general surgeon and a gynecologist. Conclusions: To the best of our knowledge, the is the first reported case of Spigelian hernia that contained part of the uterus and the left adnexa. [ABSTRACT FROM AUTHOR]

Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the "recoil ring" from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis. [ABSTRACT FROM AUTHOR]

Congenital lumbar hernia is a rare disease affecting mainly infants. Its association with lumbo-costo-vertebral syndrome (LCVS) is hardly seen in the literature. We present a case of LCVS in a 1-month-old female infant presenting with a soft bulge in left lumbar region. Abdominal X-ray revealed absence of multiple ribs with a mild lumbar scoliosis and defective ninth vertebra. Ultrasonography showed absence lateral abdominal wall muscles in left lumbar region and 2.5 cm diameter lumbar hernia. Primary repair of the adnominal wall defect was performed without meshplasty and no recurrence was reported. We hope to enhance the literature of this rare disease with our case. [ABSTRACT FROM AUTHOR]

Background. Herniation of the liver through the anterior abdominal wall is an extremely rare phenomenon. Most cases occur within an incisional hernia (mostly upper abdomen surgery or cardiac surgery). Only two reports mentioned liver herniation without previous abdominal incision. Case Presentation. We report the case of a 70-year-old woman presenting an epigastric swelling. Radiological findings showed a liver herniation in a primary ventral hernia. This case is the first to have been described requiring semiurgent hernia repair associated with partial liver resection. Conclusion. This case is, to the best of our knowledge, the first case of primary ventral hernia with liver content necessitating wedge resection of the left liver lobe. [ABSTRACT FROM AUTHOR]

Background. Spigelian hernia is an uncommon presentation of abdominal hernias with 0.1-2%. We report a case of a large strangulated Spigelian hernia, an uncommon presentation of abdominal hernias, and its management in a health facility in Central Uganda. Case Presentation. A 76-year-old female presented with a 2-day history of colicky abdominal pain, bilious vomiting, and abdominal distension. On abdominal ultrasound scan, an abdominal wall defect measuring 4.45 cm with herniated bowel loops in the left anterior abdominal region with mild fluid collection in the hernia sac was seen. Conservative management for intestinal obstruction which included putting the patient on nil per os, NG tube decompression, and soapy enema was instituted, and surgery was done on the second day of admission. Intraoperatively, using a Rutherford-Morrison incision, we found a large defect at the Spigelian aponeurosis, with an inflamed sac protruding. The Spigelian hernia was repaired with a mesh under layers. The patient recovered uneventfully and was discharged 10 days after surgery. Conclusion. Clinicians and especially general surgeons might be aware of this rare condition in most of the anterior abdominal swellings. Strangulation is the commonest complication of Spigelian hernia, and surgical management remains the mainstay of its treatment. [ABSTRACT FROM AUTHOR]

To present factual data on the medico-legal aspects of medicolegal claims after abdominal wall surgery in France. Analysis of the complaints following parietal surgery that were addressed to a company that specializes in medical malpractice insurance between 2010 and 2016. Of 209 files, 180 were analyzable; these included 75 women and 105 men with a mean age of 51 years and a mean BMI of 29.8. Cases were mainly heard by the Conciliation and Compensation Commission (CCI) (82 patients) and the High Court (79 patients). The surgical procedures concerned were groin hernias (85 patients) or anterior abdominal wall hernias (95 patients). Conventional open surgery was performed in 123 patients and laparoscopic surgery in 57 patients. The incidents motivating patient complaints after groin hernia surgery were chronic pain (27 patients), infection (24 patients), testicular damage (10 patients). Seven patients died as a result of this surgery (including one fetus). Claims after ventral hernia repair were motivated by infections (46 patients) and post-operative peritonitis or bowel obstruction (12 patients). Nine patients died following these ventral hernia repairs. Surgical error was identified in 59 of the 168 cases analyzed (35.1%); 44% of recognized faults were surgical site infections, 27% linked to delay in re-operation, and 20% were related to the operating room environment. Hernia surgery, although an everyday event for many practitioners, requires the same rigor as all other visceral surgery. [ABSTRACT FROM AUTHOR]

Spigelian hernia is one of the most uncommon hernia of the abdominal wall. Authors present 53 years old women with left sided spigelian hernia containing: caecum with appendix and ileum, which was an uncommon content of hernial sac. Past medical history of urinary bladder operation suggested postoperative hernia. However, the correct diagnosis was made during the operation. Hernioplasty was made with mesh onlay method. The postoperative course was unevenful. [ABSTRACT FROM AUTHOR]

We describe the original technique used for the treatment of a patient who presented with pain and bulging in the abdomen, who was diagnosed with Spigelian hernia (SH) using ultrasound. In this case, the hernia occurred in the anterolateral abdominal wall with herniation of the distal ileum and mesentery, in addition to a large right inguinal hernia. A mini‑laparoscopic approach was proposed; due to Child‑A hepatic cirrhosis, it was done by a hybrid technique, using a harmonic scalpel. The primary closure of the hernia defects was performed, followed by the placement of a polypropylene mesh in the preperitoneal space. The mesh was fixed. In this case, the inguinal hernia was homolateral to the SH. Following the surgery, the patient had no further complications, being discharged the day after the procedure. [ABSTRACT FROM AUTHOR]

Bilateral hernias being done simultaneously is quite a common procedure. Sometimes, a para umbilical hernia is fixed at the same time as well. However, it is rare to fix more than three hernias of the abdominal wall simultaneously. This case report presents a 73-year-old gentleman who underwent mesh hernioplasty of the hiatus, an epigastric hernia, a paraumbilical hernia, a Spigelian hernia, and bilateral inguinal hernia repair as well, all done in a single session. On follow-up at one year, he was asymptomatic, with no complications attributable to the multiple hernia meshplasty. This case report is being published to reiterate that multiple abdominal wall deficiencies can be corrected in a single sitting, which is advantageous in terms of cost and the need for multiple admissions, especially for patients from remote areas. [ABSTRACT FROM AUTHOR]