title: Laparoscopic and perineal approaches to perineal hernia repair.
abstract: BACKGROUND
  Perineal hernias after abdominoperineal resection (APER) of the rectum appear to be becoming more common, but there only a small number of reported cases, with very few reports discussing more than one or two. There is little consensus as to the optimal method of repair. We report the successful management of 7 cases of postoperative perineal hernia, including a hernia around a gluteal rotation flap that has not previously been reported, and discuss the operative approaches.
  
  
  METHODS
  We performed a single-centre hospital database review over 6 years.
  
  
  RESULTS
  Seven perineal hernias occurred after APER and were repaired. Six were treated with a transabdominal approach (5 laparoscopic and 1 laparoscopic converted to open) and one perineal approach. In 4 cases, a synthetic composite mesh was used, in 2 a biological mesh and in one direct suture repair. There have been no recurrences during a median follow-up of 25 months.
  
  
  CONCLUSIONS
  Laparoscopic mesh repair of symptomatic perineal hernia is the method of choice in most cases. Herniation may still occur despite inset of a gluteal rotation flap at initial APER and laparoscopic repair in that instance is difficult.
authors: The Department of Colorectal Surgery, The Rotherham NHS Foundation Trust, Moorgate Road, Rotherham, South Yorkshire, S60 2UD, UK.
authors: Y
authors: Y
authors: Abbas
authors: J
authors: J
authors: Garner
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006547:Hernia / Q000628:therapy*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications; D013526:Surgical Mesh; D016896:Treatment Outcome
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