Abstract
Flank or lateral incisional hernias are very rare but may be very challenging to manage them. To handle these hernias a previous classification, an early diagnosis, and a tomography are necessary. Delaying surgery only prolongs the patient’s suffering, aggravates the problem, and worsens the prognosis. Knowledge about the topographic anatomy is essential to perform surgery safely. The dissection of the bone edges and medial areas (rectus sheath) is difficult and limited. Fixation on these areas must be firm. The laparoscopic approach is a safe option for small or moderate defects in patients with BMI <30. For subcostal hernias an open approach is safer. Large hernias (>15 cm) and on obese patients this approach should be preferred and the double-mesh technique is the best choice. As with other complex abdominal wall hernias, we advise that patients with complex lateral hernias should be treated in specialized units.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tatay FC, Diana SB, Pastor PG, I Gavara CG, Valdelomar RB. New surgical technique in complex incisional hernias: component separation technique (CST) with prosthesis and new muscle insertions. Cir Esp. 2009;86(2):87–93.
Tatay FC, Pastor PG, Lledó JB, Ortiz MS, Diana SB, Hernández JI, Olamendi F. Subxiphoid incisional hernia treatment: a technique using a double mesh adjusted to the defect. Cir Esp. 2011;89(6):370–8.
Tatay FC, Moreno Egea A. Eventraciones. Otras hernias de la pared y cavidad abdominal. Picanya, Valencia: Editorial Gràfiques Vimar; 2012.
Hope WW, Hooks 3rd WB. Atypical hernias: suprapubic, subxiphoid, and flank. Surg Clin North Am. 2013;93(5):1135–62.
Lal R, Sharma D, Hazrah P, Kumar P, Borgharia S, Agarwal A. Laparoscopic management of nonmidline ventral hernia. J Laparoendosc Adv Surg Tech A. 2014;24(7):445–50.
Moreno-Egea A, Carrillo A, Aguayo JL. Midline vs non-midline laparoscopic incisional hernioplasty: a comparative study. Surg Endosc. 2008;22(3):744–9.
Moreno-Egea A, Mengual-Ballester M, Cases-Baldó MJ, Aguayo-Albasini JL. Repair of complex incisional hernias using double prosthetic repair: single-surgeon experience with 50 cases. Surgery. 2010;148(1):140–4.
Moreno-Egea A, Carrillo-Alcaraz A. Management of non-midline incisional hernia by the laparoscopic approach: results of a long-term follow-up prospective study. Surg Endosc. 2012;26(4):1069–78.
Moreno-Egea A, Sanchez-Elduayen M, De Andres EP, Carrillo-Alcaraz A. Is muscular atrophy a contraindication in laparoscopic abdominal wall defect repair? A prospective study. Am Surg. 2012;78(2):178–84.
Moreno-egea A, Aguayo JL. Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study. Am J Surg. 2012;203(1):87–94.
Moreno-Egea A, Alcaraz AC, Cuervo MC. Surgical options in lumbar hernia: laparoscopic versus open repair. A long-term prospective study. Surg Innov. 2013;20(4):331–44.
Moreno-Egea A. The double prosthetic repair technique (according to Moreno-Egea) as a solution for large subcostal hernias. Rev Hispanoam Hernia. 2014;02:9–12.
Moreno-Egea A. Double prosthetic repair for complex incisional hernia repair: long-term results and evolution of the technique. Am Surg. 2015;81(11):1138–43.
Veyrie N, Poghosyan T, Corigliano N, Canard G, Servajean S, Bouillot JL. Lateral incisional hernia repair by the retromuscular approach with polyester standard mesh: topographic considerations and long-term follow-up of 61 consecutive patients. World J Surg. 2013;37(3):538–44.
Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Matsutani T, Uchida E. Kawano Y. Laparoscopic mesh repair for lumbar hernia after iliac crest bone harvest. Asian J Endosc Surg 2016. doi: 10.1111/ases.12308 [Epub ahead of print].
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Tatay, F.C., Moreno Egea, A., Latifi, R. (2017). Management of Flank Complex Hernia. In: Latifi, R. (eds) Surgery of Complex Abdominal Wall Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-55868-4_17
Download citation
DOI: https://doi.org/10.1007/978-3-319-55868-4_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-55867-7
Online ISBN: 978-3-319-55868-4
eBook Packages: MedicineMedicine (R0)