OGBN V07 Laparoscopic repair of rare case of interparietal port-site incisional hernia with mesh in sub-lay; pre-peritoneal space

Abstract Background Interparietal hernias are defined as protrusions of intraabdominal contents within the layers abdominal wall. Primary interparietal hernias; like Spigelian's hernia rare, 0.12% to 2% all wall hernias. Recently, more encountered incisional However, very few cases have been reported in literature at port site following laparoscopic surgery, keeping mind that incidence varies between 0.74% 1.47% after surgical procedures. Here we presenting a rare case hernia, its management and summarising key steps for mesh sub-lay (pre-peritoneal) plane with defect closure. Methods We present 72-year-old gentleman, who had robotic prostatectomy January 2020. He presented towards end year left lower ache discomfort. On examination he bout 2 cm palpable LLQ 11 mm port. CT scan confirms where internal muscles damaged, but external oblique muscle remains intact. Hernia MDT discussion advised conservative management, given low probability incarceration current anatomy, intervention if affecting daily activity lifestyle. Clinical review one year, patient describes discomfort dull pain increases his usual gardening, walking or running, necessitating increasing analgesia 2,3. The believes this is life. Repeat showed muscular iliac fossa, rectus abdominis medially retracted transversus laterally. facia along anterior sheath After further regarding risks vs benefits, opted treatment approach Results Patient supine position. Pneumoperitoneum created using Veress needle Palmer's point, 11mm optical-port right lumbar area. Laparoscopy confirmed bulging pre marked another 2×5 ports. Bulging identified site. Anterior parietal peritoneum incised vertically midline dissection carried out laterally develop pre-peritoneal space. Defect exposed assessed. There was horizontal rupture arcuate ligament across posterior exposing section inferior epigastric vessels muscle. This extends involve transverse abdominus obliques total size 6×3 cm. closed 1.0-Ehtilon introduced Endo Close leaving free outside. continuously two then extracted tied trans-fascially under pressure procedure. 20.3×15.2 Ventralight ST Mesh placed peritoneal marking centre 2.0-Prolene stitch used anchor mesh. only fixed AbsorbaTack avoid post operative pain. Then midline, covering AbsorbaTack. Conclusions usually discomfort, acutely due strangulation. Very little presentation literature. abstract Furthermore, describe an repair without disturbing intact fascia, utilizing combination closure synthetic prothesis space, thus minimising chance future complication. highlights not importance closing than importantly need make sure included