Laparoscopic repair of an anterior perineal hernia: a video presentation.

Abstract

<h4>Background</h4>The perineal hernia is a condition that occurs as a result of a defect in the pelvic diaphragm. It is classified as anterior or posterior, and as either a primary or secondary hernia. The best management of this condition remains controversial.<h4>Objectives</h4>To demonstrate the surgical steps of a laparoscopic repair with mesh of a perineal hernia.<h4>Materials and methods</h4>A video presentation showing the laparoscopic repair of a recurrent perineal hernia.<h4>Main outcome measures</h4>A 46-year-old woman with a prior history of a primary perineal hernia repair had complaints of a symptomatic vulvar bulge. Pelvic magnetic resonance imaging showed a 5 cm hernia sac at the right anterior pelvic wall containing adipose tissue. A laparoscopic perineal hernia repair was performed by dissection of the space of Retzius, reduction of the hernial sac, closure of the defect and mesh fixation.<h4>Results</h4>The laparoscopic repair with mesh of a recurrent perineal hernia is demonstrated.<h4>Conclusion</h4>We showed that the laparoscopic approach can be an effective and reproducible treatment for perineal hernia.<h4>Learning objective</h4>Understanding of the surgical steps involved in the laparoscopic repair with mesh of a recurrent perineal hernia.