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J Minim Access Surg. 2018 Sep 3. doi: 10.4103/jmas.JMAS_179_18. [Epub ahead of print]

A new hybrid mini-laparoscopic technique for Spigelian hernia.

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Department of General Surgery, Faculty of Medical Sciences; Member of UNIPECLIN (Clinical Research Group of the University of Pernambuco), University of Pernambuco; Videolaparoscopic Surgery Clinic Gustavo Carvalho, Recife, Brazil.
Department of General Surgery, Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
Department of General Surgery, Pernambuco Health College, Recife, Brazil.
Department of General Surgery, State Servers Hospital, Recife, Brazil.


We describe the original technique used for the treatment of a patient who presented with pain and bulging in the abdomen, who was diagnosed with Spigelian hernia (SH) using ultrasound. In this case, the hernia occurred in the anterolateral abdominal wall with herniation of the distal ileum and mesentery, in addition to a large right inguinal hernia. A mini-laparoscopic approach was proposed; due to Child-A hepatic cirrhosis, it was done by a hybrid technique, using a harmonic scalpel. The primary closure of the hernia defects was performed, followed by the placement of a polypropylene mesh in the preperitoneal space. The mesh was fixed. In this case, the inguinal hernia was homolateral to the SH. Following the surgery, the patient had no further complications, being discharged the day after the procedure.


Hernia repair; Spigelian hernia; hybrid approach; mini-laparoscopy; minimally invasive surgery

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