Bilateral Spiegelian Hernia: Surgical Management with Extended-View Totally Extraperitoneal (eTEP) Approach. Case Report

Casahuamán-Urquía M.C.; Ramos-Ramos V.E.; Montenegro-Perez J. · Revista Medica Herediana (2025) · DOI: 10.20453/rmh.v36i4.6273

Resumen

A Spigelian hernia is rare, especially if bilateral. Due to its infrequent occurrence, nonspecific symptoms, and challenging examination, it can go unnoticed, leading to underdiagnosis and underreporting. A high index of suspicion, thorough examination, and imaging are essential for timely diagnosis. For treatment, the laparoscopic Extended-view Totally Extraperitoneal (eTEP) approach offers notable benefits by providing a large surgical workspace, reducing recurrence, enabling faster recovery, minimizing postoperative pain, and yielding better aesthetic outcomes. We present the case of a 66-year-old woman with intermittent, sharp, vaguely localized abdominal pain that had evolved over 16 years, increasing in intensity over the last 6 months, and localizing to the flank and iliac fossae. Following physical examination and computed tomography imaging, a diagnosis of bilateral Spigelian hernia was made. She underwent laparoscopic eTEP surgical repair, demonstrating the characteristic advantages of this technique: rapid recovery, absence of pain, and prompt return to her daily activities. © The authors. Revista Médica Herediana. Open access article, distributed under the terms of the Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by-nc-nd/4.0/.

Instituciones: Universidad Peruana Cayetano Heredia