Mesh-based transperineal repair of a perineal hernia after a laparoscopic abdominoperineal resection

• Published in: Annals of coloproctology Vol. 30; no. 4; pp. 197 - 200
• Main Authors: Lee, Taek-Gu, Lee, Sang-Jeon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Coloproctology 01-08-2014; 대한대장항문학회
• Subjects: Case Report; 일반외과학; Transperineal approach; Laparoscopic abdominoperineal resection; Perineal hernia; Synthetic mesh
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2014.30.4.197

A perineal hernia (PH) is formed by a protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after a conventional abdominoperineal resection (APR). However, the risk of a PH may be increased after a laparoscopic resection because this technique can cause fewer postoperative adhesions, predisposing the small bowel to sliding down toward the pelvis. However, only a few case reports describe the transperineal approach for the repair of a PH after a laparoscopic APR. We present a case of a PH after a laparoscopic APR; the PH was repaired with synthetic mesh by using a transperineal approach. A transperineal approach using a mesh to reconstruct the pelvic floor is less invasive and more effective. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.