Successful laparoscopic repair of a lumbar hernia occurring after iliac bone harvest.
BACKGROUND
Many techniques have been described for the surgical repair of lumbar hernias, including primary repair, local tissue flaps, and conventional mesh repair. All these open techniques require a large incision plus extensive dissection to expose the hernia ring. This report presents a case of a recurrent lumbar hernia, which was successfully repaired using a laparoscopic approach.


METHODS
A 75-year-old female presented with a symptomatic right lumbar hernia, 1-year after an iliac bone harvest for knee surgery. Under general anesthesia, the patient was placed in a lateral decubitus position. A 3 trocar technique was used to do adhesiolysis of the surrounding tissues, to provide an ample working space to identify the hernia. A composix dual mesh (bard) was tailored so that it would overlap the defect with intermittent fixation by a spiral tacker (protac). No hernia recurrence occurred over 2 years after surgery.


CONCLUSIONS
The laparoscopic approach has significant advantages for the repair a lumbar hernia: it enables the exact localization of the anatomic defect, and the mesh can be placed deep into the defect, thus allowing the intraabdominal pressure to hold it in position.
Kawashita
Yujo
Y
Department of Surgery, Nagasaki Rosai Hospital, Setogoshi, Sasebo City, and Department of Transplantation and Digestive Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan. yujongs@gmail.com
Iwata
Toru
T
Kanetaka
Kengo
K
Ono
Shinichiro
S
Matsuo
Mitsutoshi
M
Nagayoshi
Shigeki
S
Kanematsu
Takashi
T
D000368:Aged; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008161:Lumbosacral Region / Q000601:surgery*; D012008:Recurrence