Laparoscopic repair of a large perineal hernia after laparoscopic abdominoperineal resection: A case report

• Published in: Asian journal of endoscopic surgery Vol. 12; no. 2; pp. 204 - 206
• Main Authors: Kakiuchi, Daiki, Saito, Kenichiro, Mitsui, Takeshi, Munemoto, Yoshinori, Takashima, Yoshihiro, Amaya, Susumu, Shimada, Masanari, Kato, Yosuke
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.04.2019; Wiley Subscription Services, Inc
• Subjects: Case reports; Hernias; Laparoscopic abdominoperineal resection; laparoscopic mesh repair; Laparoscopy; perineal hernia; laparoscopic mesh repair; Laparoscopic abdominoperineal resection; perineal hernia
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12612

A 75‐year‐old woman underwent laparoscopic abdominoperineal resection. Four months after abdominoperineal resection, the patient complained of a perineal bulge and urination disorder. Abdominal CT showed protrusion of the small intestine and bladder to the perineum. The patient underwent laparoscopic hernia repair with mesh. The size of the hernial orifice was 7.0 × 9.0 cm, and it had no solid rim. The mesh was tacked ventrally to the pectineal ligament and dorsally to the sacrum, and then sutured on the lateral side. The hernia has not recurred 10 months after the operation. Laparoscopic repair is a good treatment choice for secondary perineal hernia and fixing the mesh to the pectineal ligament, and the sacrum prevents the mesh from sagging.