Laparoscopic Transiliac Hernia Repair

Abstract

Introduction:

Transiliac hernias are very rare and occur through a defect in the iliac bone. Most transiliac hernias occur following full-thickness bone graft procurements; however, pelvic trauma has been reported as an extremely rare etiology for transiliac hernias. ^1,2 Most are repaired by an open surgical approach, but more recently, laparoscopic techniques are being used. ³

Materials and Methods:

We present a case of a 77-year-old gentleman, with a remote history of pelvic trauma, who presented with 4 months of intermittent left flank pain. On examination, pain could be reproduced by pressing on a bulge over an irregular edge of the left iliac crest. An abdominal CT scan revealed a loop of small intestine herniating through a bony defect over the left iliac crest consistent with a transiliac hernia. The patient subsequently underwent a laparoscopic hernia repair with a polyester composite mesh.

Results:

The patient tolerated the procedure well and was discharged home on postoperative day 2. His left flank pain completely resolved after the surgery. On 6-month follow-up, there was no clinical evidence of recurrence, and a repeat CT scan demonstrated an intact repair.

Conclusions:

This case illustrates an extremely rare complication following a pelvic fracture. Historically, these hernias have been repaired with an open technique, but a laparoscopic approach is feasible with good results.

No competing financial interests exist.

Runtime of video: 6 mins 25 secs

Presented at the American College of Surgeons in October 2015 in Chicago, IL.