Laparoscopic repair of secondary perineal hernia with coverage by the mobilized cecum. Issue 4 (23rd November 2018)

• Record Type: Journal Article
• Authors: Kato, Shoko; Ishiguro, Seiji; Komatsu, Shunichiro; Matsumura, Tatsuki; Yasui, Kohei; Komaya, Kenichi; Saito, Takuya; Arikawa, Takashi; Kaneko, Kenitiro; Sano, Tsuyoshi
• Is Part Of: Asian journal of endoscopic surgery. Volume 12:Issue 4(2019)
• Page Start: 482
• Page End: 485
• Publication Date: 2018-11-23
• Subjects: Herniorrhaphy -- laparoscopic surgery -- perineal hernia; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12669
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: The 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 avoids mesh‐related complications.