Laparoscopic transabdominal preperitoneal repair of Spigelian hernia a case series and literature review

INTRODUCTION: Spigelian hernia (SpH) is an uncommon abdominal wall defect characterized by protrusion of preperitoneal fat or a peritoneal sac through Spigelian’s aponeurosis. Most cases occur within the “Spigelian hernial belt,” between the umbilicus and the interspinal line. Diagnosis is challenging, often requiring imaging, and surgical repair remains the treatment of choice. PATIENTS AND METHODS: We conducted a retrospective review of four patients with SpH who underwent laparoscopic transabdominal preperitoneal (TAPP) repair between June 2023 and March 2025. Clinical presentation, operative details, and postoperative outcomes were analyzed. All diagnoses were confirmed by computed tomography (CT), with a mean hernial ring diameter of 2.1 cm. Repair involved reduction of the hernial contents, selective defect closure, and placement of a polypropylene mesh. DISCUSSION The TAPP approach provided optimal anatomical exposure, facilitated thorough assessment of the hernia sac, and enabled safe repair. Its use in both elective and emergency cases demonstrated favorable outcomes in terms of pain control, recovery time, and complication rates. CONCLUSION Laparoscopic TAPP repair for SpH is a safe, effective, and reproducible technique, even in emergency settings. Advantages include short operative time, prompt postoperative recovery, and a low risk of complications when performed by surgeons experienced in laparoscopic surgery.