Laparoscopic repair of postoperative perineal hernia |
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Authors: | J-L Dulucq P Wintringer A Mahajna |
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Institution: | (1) Department of Digestive Surgery, ILS, Maison de Santé Protestante Bagatelle, Route de Toulouse 203, Talence-Bordeaux, 33401, France |
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Abstract: | Background Perineal hernia is an uncommon complication following abdominoperineal resection of the rectum. There are only a few reports
concerning the management of this unusual problem. Various methods of repair have been described, but none of them is well
established. The purpose of our study is to present our experience and to discuss the pathogenesis and the different surgical
repair techniques of these hernias.
Methods Between September 2003 and December 2004, four patients with perineal hernia observed several months following laparoscopic
abdominoperineal resection for adenocarcinoma of the lower rectum were treated. All patients underwent the transabdominal
laparoscopic approach using synthetic mesh for repair.
Results In all patients, the hernia was repaired by the laparoscopic transabdominal approach using synthetic mesh. The blood loss
was minimal and mean operating time was 54 ± 10 min. There were no cases that required conversion to laparotomy and there
were no intraoperative or postoperative complications. Beginning of soft diet intake and ambulation times were on the second
day following surgery. The average length of hospital stay was 4 ± 1 days. During 8.3 ± 6 months of follow-up, there was no
recurrence of the hernia.
Conclusion Perineal hernias are rare complications of major pelvic surgeries. Symptomatic hernias should be repaired surgically. The
transabdominal laparoscopic approach using synthetic mesh provides an appropriate solution for these hernias. |
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Keywords: | Perineal hernia Laparoscopic repair Postoperative Synthetic mesh |
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