title: Grynfelt-Lesshaft hernia a case report and review of the literature.
abstract: BACKGROUND
  Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life.
  
  
  METHODS
  A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type "A" lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO(®) mesh fixed with PDS(®) II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication.
  
  
  CONCLUSIONS
  Primary (spontaneous) lumbar hernias represent 50-60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH.
  
  
  CONCLUSIONS
  The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: C F
authors.initials: CF
authors.lastname: Ploneda-Valencia
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: E
authors.initials: E
authors.lastname: Cordero-Estrada
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: L G
authors.initials: LG
authors.lastname: Castañeda-González
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: V H
authors.initials: VH
authors.lastname: Sainz-Escarrega
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: O
authors.initials: O
authors.lastname: Varela-Muñoz
authors.affiliation: Coordinator of Investigation of the Department of Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: L F
authors.initials: LF
authors.lastname: De la Cerda-Trujillo
authors.affiliation: Department of General Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: C A
authors.initials: CA
authors.lastname: Bautista-López
authors.affiliation: Chief of the Department of Surgery at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: C R
authors.initials: CR
authors.lastname: López-Lizarraga
keywords: Grynfelt hernia; Grynfelt-Lesshaft hernia; Lumbar hernia; Sandwich technique