Perineal hernia – different surgical approaches and treatment techniques. A case report

Abstract

This is a case report of a 69-year-old woman who presented major perineal hernia in the scar after a surgical resection of rectal cancer (adenocarcinoma) and hysterectomy. She was repaired by an open repair using a partially absorbable anti-adhesive intraperitoneal implant which was styled to the size and contours of the minor pelvis. Symptomatic perineal herniation after surgical resections is a rare phenomenon so only several different surgical approaches and techniques of the repair have been described. This report presents an overview of different surgery techniques which depend on the size of the perineal ring as well as on whether plastic reconstruction of the fascia is needed or not. The analysis leads to the conclusion that all cases require tailored approaches and surgeons need to be prepared for conversion to a different technique even in the course of the surgery.

Keywords

• secondary perineal hernia
• laparoscopy
• abdominoperineal approach
• mesh