“A Spigelian Hernia (or Lateral Ventral Hernia) is a Hernia through the speigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally.”

THE CASE

A 64 year old lady with a long history of Hypertension, was suffering from periodical pain in the lower abdomen, more on the right side.

The pain was mild in nature accompanied by constipation with occasional urinary discomfort. She was previously treated by private practitioners and had undergone abdominal ultrasound twice which revealed no abnormality. However, when the patient visited BLK hospital, she was advised CECT abdomen which revealed the presence of a hernial defect in the right anterolateral abdomino-pelvic wall with presence of intra-abdominal omental fat in the inter muscular plane. Patient was diagnosed as a case of Spigelian Hernia which is a rare form of Abdominal Wall Hernia.






THE PROCEDURE

The patient underwent Laparoscopic Hernia Repair. Intra-operative, a defect of 3 x 3 cm was detected at the right lumbar area consistent with a Spigelian Hernia. Laparoscopic intra-peritoneal onlay mesh repair was done using a Parietex mesh and Protack absorbable takers. The Hernia measured 10.4 x 4 cm.

THE RESULT

The procedure was uneventful and the patient is recovering well. Her pain has reduced gradually. She was discharged soon after the surgery. Apart from routine check ups, she is relatively free of any pain or other symptoms.