Laparoscopic repair of secondary perineal hernia with coverage by the mobilized cecum

AbstractThe incidence of secondary perineal hernia (SPH) has increased since the introduction of extralevator abdominoperineal resection and laparoscopic abdominoperineal resection. Currently, laparoscopic mesh repair is the usual procedure. Here, we demonstrate a repair of SPH without mesh that uses the mobilized cecum to cover the pelvic hernial orifice. An 83 ‐year‐old man complained of discomfort when sitting for long periods. He was status post laparoscopic abdominoperineal resection and was diagnosed with SPH. Hernia repair was performed. After transperitoneal adhesiolysis in the inferior pelvis, the right colon was laparoscopically mobilized, and the pelvic orifice was covered by suturing the cecum to the pelvic brim. The perineal skin was managed with negative pressure wound therapy. The postoperative course was uneventful. There has been no sign of recurrent herniation for 12 months. This method of SPH repair is simple to perform and av oids mesh‐related complications.

Source: Asian Journal of Endoscopic Surgery - November 23, 2018 Category: Surgery Authors: Shoko Kato, Seiji Ishiguro, Shunichiro Komatsu, Tatsuki Matsumura, Kohei Yasui, Kenichi Komaya, Takuya Saito, Takashi Arikawa, Kenitiro Kaneko, Tsuyoshi Sano Tags: Case Report Source Type: research