Minimal invasive mesh repair of bilateral inguinal and Spigelian hernia in one patient and review of literature

Background. Spigelian hernia is a rare condition traditionally treated with open approach. This article reports a case with bilat-eral inguinal and Spigelian hernia repaired using total extraperitoneal approach (TEP) and reviews the literature to compare TEP with different laparoscopic approaches, for safety and recurrence rate in the treatment of Spigelian hernia Material and Methods. We conducted a search in PubMed to review laparoscopic repair of Spigelian hernia and analysed them for for various parameters as sex, hernia location, diagnosis, complications, follow-up and recurrence rate Results. A total of 33 articles were included, encorporting 59 cases. Comparison of intraperitoneal onlay mesh IPOM (n=24), transabdominal preperitoneal repair TAPP(n=21) and TEP(n=14) showed no difference in recurrence rate, as all three methods were reported without recurrence. TEP was also without complications whereas in one case IPOM and TAPP postoperative seroma was reported. Conclusion. This case shows the feasibility of laparoscopic TEP approach even when there is bilateral inguinal and Spigelian her-nia. The review of literature supports our opinion that TEP, compared to IPOM and TAPP, is feasible, safe and effective and might reduce the risk of complications.