Tensionless Spigelian herniorrhaphy using a bilayered prosthetic patch: historical, anatomical, diagnostic, and operative perspectives

Spigelian hernias, which represent <2% of all hernias of the vellum abdominis (abdominal wall) anterior, can be a diagnostic challenge for clinicians. Noninvasive imaging techniques, including ultrasonography (US) and computerized axial tomography (CAT), substantially complement clinical inferences based on interrogation and physical examination. Successful definitive care mandates comprehension of the regional, topographical, and visceral anatomy in axial, coronal, and transverse planes. Reported herein is the successful use of a bilayered prosthetic patch, advantageous because of its unimodular and biplanar configuration, to perform a tensionless herniorrhaphy.