LAPAROSCOPIC REPAIR OF LUMBAR HERNIAS

Background: Lumbar hernias are rare defects in the posterolateral abdo minal wall that may be congenital or acquired. Repairing these defects is difficult by virtue of their location and the inherent weakness of the surrounding tissues. We report a series of seven patients who had their lumbar hernias repaired laparoscopically at two institutions. S tudy Design: We retrospectively reviewed all lumbar hernias repaired l aparoscopically in our institutions within the last 16 months (August 1996 to November 1997). Postoperative followup was 1-15 months. Result s: Seven patients underwent laparoscopic repair. Five hernias were acq uired defects and two were congenital. One to three defects were found per patient. The average size of the hernia defect was 77.8 cm. We us ed a polypropylene or a polytetrafluoroethylene mesh in all patients; the average size of the mesh used was 336.4 cm(2). The average length of hospital stay was 1.7 days. One patient returned with an abscess ov er the mesh, which necessitated removal of the graft. Otherwise, there were no complications, and the remaining six patients had no recurren ces after followup of 1-14 months. Conclusions: The laparoscopic appro ach is safe and effective for repairing lumbar hernias. Advantages of this approach include excellent operative visualization, decreased hos pital stay postoperatively, and a solid repair without recurrence duri ng shortterm followup. (J Am Coll Surg 1998;187:147-152. (C) 1998 by t he American College of Surgeons)