A novel mini-open sublay hernioplasty combined with D10 mesh for primary lumbar hernia: a retrospective analysis of 48 cases

BACKGROUND

The aim of this study was to explore the safety and efficacy of a novel mini-open sublay hernioplasty with D10 mesh for primary lumbar hernias.

METHODS

This retrospective study included 48 patients with primary lumbar hernias who underwent mini-open sublay hernioplasty with D10 mesh from January 2015 to January 2022 in our hospital. Observation indicators were intraoperative measured diameter of hernia ring defect, operation time, length of hospital stay, postoperative follow-up, complications, postoperative visual analog scale (VAS) score, chronic pain.

RESULTS

The operations were completed successfully in all 48 cases. The mean diameter of hernia ring was 2.66 ± 0.57 cm (range 1.5-3.0 cm), the mean operation time was 41.54 ± 13.21 min (range 25-70 min), the intraoperative blood loss was 9.89 ± 6.16 ml (range 5-30 ml), and the mean hospital stay was 3.14 ± 1.53 days (range 1-6 days). The mean preoperative and postoperative VAS scores at 24 h were 0.29 ± 0.53 (range 0-2) and 2.52 ± 0.61 (range 2-6), respectively. All cases were followed-up for 53.4 ± 24.3 months (range 12-96 months) without seroma, hematoma, incision or mesh infection, recurrence, and obvious chronic pain.

CONCLUSION

A novel mini-open sublay hernioplasty with D10 mesh for primary lumbar hernias is safe and feasible. Its efficacy in the short term is favorable.

Primary Jean Louis Petit and Grynfeltt-Lesshaft concomitant hernias: A case report

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Primary lumbar hernia.

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Concomitant lumbar hernias : Jean Louis Petit and Grynfeltt-Lesshaft.

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Misdiagnosis hernia.

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Surgical approach.

Introduction

Posterior abdominal wall hernias are rare, mainly post traumatic or post-operative. This case is particular first by its mechanism, it is a primary lumbar hernia and secondly it is a concomitant hernia of the Jean Louis Petit triangle and the Grynfeltt triangle.

Presentation of case

The patient was a 67 years old man, a former farmer. He complaint of a painful tumefaction on his back evolving for the last 2 years. After clinical examination, a diagnosis of lumbar hernia was retained. The CT scan which is the gold standard was not performed due to financial limitations. An hernioplasty with a porcine collagen mesh was done, in per operative we found a Jean Louis Petit hernia and a Grynfeltt-Lesshaft hernia. Any post-operative complications.

Discussion

Lumbar hernia is not a common diagnosis, and most of time is misdiagnosed. Acquired primary lumbar hernia can be due to profession involving lumbar constraints leading to the weakness of muscles. This was the case of our patient. Another particularity was the double hernia, the upper and lower lumbar triangles. We already know the impact of his profession and may be 20 years of this leaded to the double hernia? An hernioplasty in open surgery was proposed for multiples reasons: the age of the patient, the weakness of the muscle, a large exploration of the hernia, to reinforce the posterior lumbar wall and to prevent a recidivism.

Conclusion

Jean Louis Petit and Grynfeltt-Lesshaft hernias are very uncommon. Few cases have been reported.