title: Successful laparoscopic repair of a lumbar hernia occurring after iliac bone harvest.
abstract: 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.
authors.affiliation: 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
authors.forename: Yujo
authors.initials: Y
authors.lastname: Kawashita
authors.forename: Toru
authors.initials: T
authors.lastname: Iwata
authors.forename: Kengo
authors.initials: K
authors.lastname: Kanetaka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ono
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Matsuo
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nagayoshi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000368:Aged; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008161:Lumbosacral Region / Q000601:surgery*; D012008:Recurrence