Prevascular hernias of the abdominal wall: a difficult problem, a difficult repair.
Hernia 2014;
19:517-21. [PMID:
24752245 DOI:
10.1007/s10029-014-1243-7]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 03/27/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION
Secondary prevascular hernias occurring anterior to the iliofemoral vessels and involving the lower abdominal wall are rare. These hernias can be difficult to repair because of loss of the inguinal ligament and the musculofascial elements of the inguinal region.
MATERIALS AND METHODS
We describe a new technique of repair using an intraperitoneal sling of prosthetic material. The sling is sewn posteriorly to the anterior surface of the sacrum, and is then draped caudally to be sewn to the pubis and Cooper's ligaments before being reflected anterior to be sewn to the posterior surface of the anterior abdominal wall. This sling "patches" the hernia defect as a form of intraperitoneal sublay.
CONCLUSIONS
We describe three such patients with satisfactory results at follow-ups of 8-16 months. Potential problems and considerations are discussed.
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