Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Hernia
Published in: Hernia 6/2017

01-12-2017 | How-I-Do-It

How we do it: repair of large perineal hernia after abdominoperineal resection

Authors: J. Li, W. Zhang

Published in: Hernia | Issue 6/2017

Login to get access

Abstract

Background

Symptomatic perineal hernia is a rare complication after abdominoperineal resection (APR). Management of these hernias is challenging. The recurrence rate after surgical repair is high because of the difficulty of prosthetic material fixation; there is no consensus regarding the best method of repair.

Methods

We introduced a novel combined laparoscopic-perineal dual fixation technique in the repair of perineal hernias after APR. This technique begins with a perineal approach under laparoscopic vision. After excision of the hernia sac, the mesh is introduced and fixed anteriorly to the urogenital diaphragm and laterally to the sacrotuberous ligament and the surrounding scar tissue. The perineal incision is then closed. Next, the mesh is fixed to the sacrum with ProTack® and is fixed again to the sacrotuberous ligament via a laparoscopic approach.

Results

The dual fixation repair method is successful and without difficulties, with no recurrence at 13-month follow-up.

Conclusion

Our laparoscopic-perineal dual fixation method is a good alternative method for large perineal hernia repair after APR.
Literature
1.
Yeoman FC (1939) Hernia, perineal and pudendal. Am J Surg 43:514–520
2.
McMullin ND, Johnson WR, Polglase AL et al (1985) Postproctectomy perineal hernia: case report and discussion. Aust N Z J Surg 55:69–72CrossRefPubMed
3.
Beck DE, Fazio VW, Jagelman DG et al (1987) Postoperative perineal hernia. Dis Colon Rectum 30:21–24CrossRefPubMed
4.
5.
Portilla AG, Martin E, de Lecea CM, Gomez C, Magrach L, Cendoya I, Uzquiza E (2010) Recurrent postoperative perineal hernia: laparoscopic redo mesh repair. Hernia 14:535–537CrossRefPubMed
6.
Stamatiou D, Skandalakis JE, Skandalakis LJ, Mirilas P (2010) Perineal hernia: surgical anatomy, embryology, and technique of repair. Am Surg 76:474–479PubMed
7.
Kathju S, Lasko LA, Medich DS (2011) Perineal hernia repair with acellular dermal graft and suture anchor fixation. Hernia 15:357–360CrossRefPubMed
8.
de Campos FG, Habr-Gama A, Araujo SE, Sousa AH Jr, Nahas CR, Lupinacci RM et al (2005) Incidence and management of perineal hernia after laparoscopic proctectomy. Surg Laparosc Endosc Percutan Tech 15:366–370CrossRefPubMed
9.
Ego-Aguirre E, Spratt JS Jr, Butcher HR Jr, Bricker EM (1964) Repair of perineal hernias developing subsequent to pelvic exenteration. Ann Surg 159:66–71CrossRefPubMedPubMedCentral
10.
Martijnse IS, Holman F, Nieuwenhuijzen GA, Rutten HJ, Nienhuijs SW (2012) Perineal hernia repair after abdominoperineal rectal excision. Dis Colon Rectum 55(1):90–95CrossRefPubMed
11.
Skipworth RJ, Smith GH, Anderson DN (2007) Secondary perineal hernia following open abdominoperineal excision of the rectum: report of a case and review of the literature. Hernia 11(6):541–545CrossRefPubMed
12.
Imagawa Y, Tomita K, Kitahara K, Yano K, Hosokawa K (2014) Repair of symptomatic perineal hernia with a titanium mesh. Hernia 18(4):587–590CrossRefPubMed
13.
Goedhart-de Haan AMS, Langenhoff BS, Petersen D, Verheijen PM (2016) Laparoscopic repair of perineal hernia after abdominoperineal excision. Hernia 20:741–746CrossRefPubMed
14.
Dulucq JL, Wintringer P, Mahajna A (2006) Laparoscopic repair of postoperative perineal hernia. Surg Endosc 20:414–418CrossRefPubMed
Metadata
Title
How we do it: repair of large perineal hernia after abdominoperineal resection
Authors
J. Li
W. Zhang
Publication date
01-12-2017
Publisher
Springer Paris
Published in
Hernia / Issue 6/2017
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-017-1685-9

Other articles of this Issue 6/2017

Hernia 6/2017 Go to the issue

Review

Triclosan-coated sutures and surgical site infection in abdominal surgery: the TRISTAN review, meta-analysis and trial sequential analysis

Comment

Reply to Invited comment to the ‘AbdoMAN’: an artificial abdominal wall simulator for biomechanical studies on laparotomy closure techniques. C. Hollinsky

Review

Meta-analysis of randomised trials comparing the use of prophylactic mesh to standard midline closure in the reduction of incisional herniae

Original Article

An evaluation of abdominal wall closure in general surgical and gynecological residents

Comment

Comment to: A modified Chevrel technique for ventral hernia repair: long-term results of a single centre cohort. Mommers EHH, Leenders, B.J.M., Leclercq, W.K.G. et al.

Original Article

Waiting for surgery: is waiting bad for anyone or everyone?