Lumbar Hernia

  • Maciej Śmetański
  • Karl A. LeBlanc


Lumbar hernias are a relatively uncommon type of hernia. In many surgeons’ careers, one may never be seen. Given the recent increase in various renal and spinal operations, a commensurate larger number of these hernias are being seen. This chapter will illustrate the anatomical considerations of these hernias and outline the various open, laparoscopic, and robotic methods of repair. Additionally, the difficult hybrid approach to the “denervation” hernias seen after nephrectomy is shown in detail.


  1. 1.
    Gardner GP, Josephs LG, Rosca M, et al. The retroperitoneal incision. An evaluation of postoperative flank bulge. Arch Surg. 1994;129:753–6.CrossRefGoogle Scholar
  2. 2.
    LeBlanc KA. Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair. Hernia. 2016;20(1):85–9.CrossRefGoogle Scholar
  3. 3.
    Hoffman RS, Smink DS, Noone R, et al. Surgical repair of the abdominal bulge: correction of a complication of the flank incision for retroperitoneal surgery. J Am Coll Surg. 2004;199:5.CrossRefGoogle Scholar
  4. 4.
    Adamson RJW. A case of bilateral hernia through Petit’s triangle with two associated abnormalities. Br J Surg. 1958;46:88–9.CrossRefGoogle Scholar
  5. 5.
    Myers RN, Shearburn EW. The problem of recurrent inguinal hernia. Surg Clin N Am. 1973;53:555–8.CrossRefGoogle Scholar
  6. 6.
    Watson LF. Hernia: anatomy, etiology, symptoms, diagnosis, differential diagnosis, prognosis, and the operative and injection treatment. 2nd ed. London: Harry Kimpton; 1938.Google Scholar
  7. 7.
    Geis WP, Saletta JD. Lumbar hernia. In: Nyhus LM, Condon RE, editors. Hernia. 3rd ed. Philadelphia: Lippincott; 1989.Google Scholar
  8. 8.
    Stumpf M, Conze J, Prescher A, et al. The lateral incisional hernia: anatomical considerations for a standardized retromuscular sublay repair. Hernia. 2009;13:293–7.CrossRefGoogle Scholar
  9. 9.
    Yavuz N, Ersoy YE, Demirkesen O, et al. Laparoscopic incisional lumbar hernia repair. Hernia. 2009;13:281–6.CrossRefGoogle Scholar
  10. 10.
    Kretschmer HL. Lumbar hernia of the kidney. J Urol. 1851;65:944–8.CrossRefGoogle Scholar
  11. 11.
    Esposito TJ, Fedorak I. Traumatic lumbar hernia. Case report and review of the literature. J Trauma. 1994;37:123–6.CrossRefGoogle Scholar
  12. 12.
    McCarthy MC, Lemmon GW. Traumatic lumbar hernia: a seat belt injury. J Trauma. 1996;40:121–2.CrossRefGoogle Scholar
  13. 13.
    Burt BM, Afifi HY, Wanz GE, et al. Traumatic lumbar hernia: reports of cases and comprehensive review of the literature. J Trauma. 2004;57:1361–70.CrossRefGoogle Scholar
  14. 14.
    Bathla L, Davies E, Fitzgibbons RJ, et al. Timing of traumatic lumbar hernia repair: is delayed repair safe? Report of two cases review of the literature. Hernia. 2011;15:205–9.CrossRefGoogle Scholar
  15. 15.
    Chatterjee S, Nam R, Fleshner N, et al. Permanent flank bulge is a consequence of flank incision for radical nephrectomy in one half of patients. Urol Oncol. 2004;22:36–9.CrossRefGoogle Scholar
  16. 16.
    Copeman WSC, Ackerman WL. Fibrositis of the back. Q J Med. 1944;13:37–40.Google Scholar
  17. 17.
    Faille RJ. Low back pain and lumbar fat herniation. Am Surg. 1978;44:359–61.PubMedGoogle Scholar
  18. 18.
    McCarthy MP. Obturator hernia of the urinary bladder. Urology. 1976;7:312–4.CrossRefGoogle Scholar
  19. 19.
    Zhou X, Nve JO, Chen G. Lumbar hernia: clinical analysis of 11 cases. Hernia. 2004;8:260–3.CrossRefGoogle Scholar
  20. 20.
    Solaini L, di Francesco F, Gourgiotis S, et al. A very simple technique to repair Grynfeltt-Lesshaft hernia. Hernia. 2010;14:439–41.CrossRefGoogle Scholar
  21. 21.
    Carbonell AM, Kercher KW, Sigmon L, et al. A novel technique of lumbar hernia repair using bone anchor fixation. Hernia. 2005;9:22–6.CrossRefGoogle Scholar
  22. 22.
    Aird I. Companion in surgical studies. 2nd ed. Edinburgh: Churchill Livingstone; 1957.Google Scholar
  23. 23.
    Akita K, Niga S, Yamato Y, Munata T, Sato T. Anatomic basis of chronic groin pain with special reference to sports hernia. Surg Radiol Anat. 1999;21:1–5.CrossRefGoogle Scholar
  24. 24.
    Iannitti DA, Biffl WL. Laparoscopic repair of traumatic lumbar hernia. Hernia. 2007;11:537–40.CrossRefGoogle Scholar
  25. 25.
    Palanivelu C, Rangarajan M, John SJ, et al. Laparoscopic transperitoneal repair of lumbar incisional hernias: a combined suture ‘double-mesh’ technique. Hernia. 2008;12:27–31.CrossRefGoogle Scholar
  26. 26.
    Moreno-Egea A, Torralba-Martinez JA, Morales G, Fernández T, Girela E, Aguayo-Albasini JL. Open vs laparoscopic repair of secondary lumbar hernias. Surg Endosc. 2005;19:184–7.CrossRefGoogle Scholar
  27. 27.
    Bittner R, Bingener-Casey J, Dietz U, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])—Part III. Surg Endosc. 2014;28:380–404.CrossRefGoogle Scholar
  28. 28.
    Sun J, Chen X, Li J, Zhang Y, Dong F, Zheng M. Implementation of the trans-abdominal partial extra-peritoneal (TAPE) technique in laparoscopic lumbar hernia repair. BMC Surg. 2015;15:118.CrossRefGoogle Scholar
  29. 29.
    Habib E. Retroperitoneoscopic tension-free repair of lumbar hernia. Hernia. 2003;7:150–2.CrossRefGoogle Scholar
  30. 30.
    Salameh JR, Salloum EJ. Lumbar incisional hernias: diagnostic and management dilemma. JSLS. 2004;8:391–4.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Zieren J, Menenakos C, Taymoorian K, et al. Flank hernia and bulging after open nephrectomy: mesh repair by flank or median approach? Report of a novel technique. Int Urol Nephrol. 2007;39:989–93.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.2nd Department of RadiologyMedical University of GdańskGdańskPoland
  2. 2.Department of Surgery and Hernia CenterDistrict Hospital in PuckPuckPoland
  3. 3.Department of SurgeryLouisiana State University Health Sciences CenterBaton RougeUSA
  4. 4.Minimally Invasive Surgery InstituteBaton RougeUSA

Personalised recommendations