Background:

-A hernia is a weakness in the abdominal wall. This weakness can be congenital or may develop with age or following conditions that increase intra-abdominal / physical pressure (physical exertion) or pathologies (chronic cough).

-The frequent place where it occurs is at the umbilical or epigastric level. There are also less frequent places like Spiegel’s hernia (on the lateral edge of the rectus femoris), dorsal or lumbar hernias (found in the posterior abdominal wall at the level of the lumbar region- upper lumbar triangle or Grynfelt hernia and the inferior lumbar triangle or Petit hernia).

-The laparoscopic approach is indicated for small parietal hernias or eventrations. The intervention consists of release of the hernia content, closure of the parietal defect and placement of non-absorbable prosthesis fixation to the posterior abdominal wall by absorbable screws (tacks) or biologic glue.

-A laparoscopic retro muscular approach is also possible for selected patients (eTEP).

Postoperative attitude:

-An abdominal belt is recommended postoperatively, because can reduce the pain during mobilization and therefore promotes early mobilization of the patient.

-In the evening or at Day 1 the patient will return home otherwise the patient will stay for an extra day for pain control.

Complications:

-Wound infection- manifested by local tenderness and signs of inflammation; antibiotics might be indicated

-Seroma/hematoma- due to hernia sac dissection; if the collection is small, a conservative treatment can be followed, otherwise a percutaneous or surgical drainage are possible.

1- umbilical hernia, 2-para-umbilical hernia, 3-epigastric hernia, 4-Spiegel hernia