Spigelian Hernia: Surgical Anatomy, Embryology, and Technique of Repair

@article{Skandalakis2006SpigelianHS,
  title={Spigelian Hernia: Surgical Anatomy, Embryology, and Technique of Repair},
  author={Panagiotis Skandalakis and Odyseas Zoras and John E. Skandalakis and Petros Mirilas},
  journal={The American Surgeon},
  year={2006},
  volume={72},
  pages={42 - 48}
}
Spigelian hernia (1–2% of all hernias) is the protrusion of preperitoneal fat, peritoneal sac, or organ(s) through a congenital or acquired defect in the spigelian aponeurosis (i.e., the aponeurosis of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially). Mostly, these hernias lie in the “spigelian hernia belt,” a transverse 6-cm-wide zone above the interspinal plane; lower hernias are rare and should be differentiated… 

Figures from this paper

Sonographic diagnosis of incarcerated Spigelian hernia during pregnancy
  • A. Udare, Prashant Bhalekar, P. Mondel
  • Medicine
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 2013
Management of Bilateral Spigelian Hernias
TLDR
Though a diagnostic challenge, it is important to accurately diagnose this hernia as it presents a high risk of incarceration and strangulation, with incarceration rates reported as high as 17 to 24 per cent, and surgical repair is therefore recommended when encountering the Spigelian hernia.
Strangulation and necrosis of right hemicolon as an extremely rare complication of Spigelian hernia
TLDR
A 70-year-old white female patient referred to the Surgical Department of the Western Attica Hospital with abdominal pain in the right lower quadrant (RLQ), mild abdominal distention and progressive constipation was treated with a major surgical procedure on an emergency basis.
Hernioplastia com tela pré-peritoneal no tratamento de hérnia de spiegel: Relato de caso
TLDR
The history of a 90 years old man with abdominal pain in the flank along two years, without diagnosis, even with several doctor visits is described, which confirmed the diagnostic of Spigelian hernia.
A case of incarcerated spigelian hernia causing small bowel obstruction
TLDR
A case of obese 48 years old female who presented with abdominal pain and signs of intestinal obstruction which was found out to be an incarcerated spigelian hernia is presented.
Spigelian Hernia in a 14-Year-Old Girl: A Case Report and Review of the Literature
TLDR
The anatomy, etiology, clinical presentation, instrumental diagnosis, and surgical technique of pediatric SH are described and a case of SH is reported: a 14-year-old girl presented recurrent abdominal pain associated to intermittent palpable mass in the paraumbilical region.
Spigelian hernia: a rare abdominal hernia
TLDR
This interesting case of spigelian hernia with associated port site hernia in a 53 year old female patient from Arwal district, Bihar who presented with occasional lower abdominal pain was reported.
[Spigelian hernias].
...
...

References

SHOWING 1-10 OF 25 REFERENCES
Pre-operative sonographic diagnosis of incarcerated neonatal Spigelian hernia containing the testis
TLDR
Three examples of spigelian hernia containing incarcerated testis in two neonates are described and ultrasound plays an important role in the diagnosis and management of these hernias.
Congenital spigelian hernia and cryptorchidism: cause or coincidence?
TLDR
Two infants with SH in 1-week and 3-month-old male infants also had an ipsilateral undescended testis (UDT), and the significance of this association is discussed.
Spigelian and other uncommon hernia repairs.
Spigelian Hernias: Repair and Outcome for 81 Patients
TLDR
A retrospective review of Mayo Clinic patients was performed to find patients who had undergone surgical repair of a Spigelian hernia from 1976 to 1997, finding that Mesh and laparoscopic repairs are viable alternatives to the durable results of standard primary closure.
Spigelian hernia: rare or obscure?
Facilitation of open spigelian hernia repair by laparoscopic location of the hernial defect
TLDR
A case in which the hernia could not be located at the time of operation, despite exploration, is presented, and laparoscopy performed subsequently enabled location and repair of theHernia under direct visualization, with good results.
Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial.
TLDR
The approach using extraperitoneal laparoscopy is the technique that offers best results in the elective treatment of spigelian hernia.
Concomitant Spigelian and inguinal hernias in a neonate.
TLDR
It is indicated that a Spigelian hernia can occur in neonates and synchronously with an inguinal hernia, regardless of age of presentation, and that the hernia is congenital in origin.
Spigelian hernias: a new repair technique using preshaped polypropylene umbrella plugs.
TLDR
A new modality consisting of the tension-free occlusion of the hernia ring with a preshaped polypropylene umbrella-type plug is used which simplifies the repair and has the advantage of producing minimal postoperative pain and disability.
...
...