Background: Spigelian hernia (SH) is an uncommon ventral abdominal hernia. Traditionally repaired with an open technique, the laparoscopic approach is becoming more common and widely described in the literature. We hold that the transabdominal preperitoneal (TAPP) approach restores the anatomy and prevents complications such as seroma. We present a series of SH repair carried out at a single district general hospital over the past 13 years and a review of the literature. Methods: A retrospective case note review identified SH repaired between January 2005 and March 2018 at The Queen Elizabeth Hospital, King's Lynn, Norfolk, UK. A Medline search for ‘Spigelian hernia' and ‘laparoscopic' revealed 41 papers for review. Results: 33 patients underwent repair of SH. We found that the TAPP repair with a mesh is anatomically the most sound repair, with all the added benefits of keyhole surgery, i.e. reduced hospital stay, quicker recovery, and fewer infections. Our complication rates matched those described in the literature. Conclusions: Several operative techniques have been described to repair SH. We favour the laparoscopic TAPP approach which is safe, aids in confirming the correct diagnosis, and has all the benefits of keyhole surgery.

1.
Ruiz de la Hermosa A, Amunategui Prats I, Machado Liendo P, Nevarez Noboa F, Muñoz Calero A: Spigelian hernia. Personal experience and review of the literature. Rev Esp Enferm Dig 2010;102:583-586.
2.
Takayama S, Imafuji H, Funahashi H, Takeyama H: Laparoscopic Spigelian and inguinal hernia repair with the Kugel patch. Surg Laparosc Endosc Percutan Tech 2010; 20:e76-78.
3.
Webber V, Low C, Skipworth RJE, Kumar S, de Beaux AC, Tulloh B: Contemporary thoughts on the management of Spigelian hernia. Hernia 2017;21:355-361.
4.
Cinar H, Polat AK, Caglayan K, Ozbalci GS, Topgül HK, Polat C: Spigelian hernia: our experience and review of the literature. Ann Ital Chir 2013;84:649-653.
5.
Nagarsheth KH, Nickloes T, Mancini G, Solla JA: Laparoscopic repair of incidentally found Spigelian hernia. JSLS 2011;15:81-85.
6.
Carter JE, Mizes C: Laparoscopic diagnosis and repair of Spigelian hernia: report of a case and technique. Am J Obstet Gynecol 1992;167:77-78.
7.
Moreno-Egea A, Carrasco L, Girela E, Martín JG, Aguayo JL, Canteras M: Open vs laparoscopic repair of Spigelian hernia: a prospective randomized trial. Arch Surg 2002;137:1266-1268.
8.
Spangen L: Spigelian hernia. World J Surg 1989;13:573-580.
9.
Moreno-Egea A, Campillo-Soto Á, Morales-Cuenca G: Which should be the gold standard laparoscopic technique for handling Spigelian hernias? Surg Endosc 2015;29:856-862.
10.
Leff DR, Hassell J, Sufi P, Heath D: Emergency and elective laparoscopic repair of Spigelian hernias: two case reports and a review of the literature. Surg Laparosc Endosc Percutan Tec 2009;19:e152-155.
11.
Kasirajan K, Lopez J, Lopez R: Laparoscopic technique in the management of Spigelian hernia. J Laparoendosc Adv Surg Tech A 1997;7:385-388.
12.
Williams NS, Bulstrode JK, O'Connell PR: Bailey and Love's Short Practice of Surgery, ed 26. London, CRC Press, 2013.
13.
Moreno-Egea A, Torralba JA, Aguayo JL: Totally extraperitoneal laparoscopic repair of Spigelian hernia. Eur J Coeliosurg 1999;32:83-84.
14.
Kelly ME, Courtney D, McDermott FD, Heeney A, Maguire D, Geoghegan JG, Winter DC: Laparoscopic Spigelian hernia repair: a series of 40 patients. Surg Laparosc Endosc Percutan Tech 2015;25:e86-89.
15.
Peterko AC, Kirac I, Cugura JF, Bekavac-Beslin M: Single incision laparoscopic Spigelian hernia repair - an approach with standard instrumentarium. Acta Clin Croat 2013;52:383-386.
16.
Tran H, Tran K, Zajkowska M, Lam V, Hawthorne WJ: Single-incision laparoscopic repair of Spigelian hernia. JSLS 2015;19:e2015.001644.
17.
Barnes TG, McWhinnie DL: Laparoscopic Spigelian hernia repair: a systematic review. Surg Laparosc Endosc Percutan Tech 2016;26:265-270.
18.
Barnes TG, McFaul C, Abdelrazeq AS: Laparoscopic transabdominal preperitoneal repair of Spigelian hernia-closure of the fascial defect is not necessary. J Laparoendosc Adv Surg Tech A 2014;24:66-71.
19.
Bittner JG 4th, Edwards MA, Shah MB, MacFadyen BV Jr, Mellinger JD: Mesh-free laparoscopic Spigelian hernia repair. Am Surg 2008;74:713-720; discussion 720.
20.
Palanivelu C, Vijaykumar M, Jani KV, Rajan PS, Maheshkumaar GS, Rajapandian S: Laparoscopic transabdominal preperitoneal repair of Spigelian hernia. JSLS 2006;10:193-198.
21.
Patterson A, Thomas B, Franklin A, Connor C, Pullatt R: Transabdominal preperitoneal repair of Spigelian hernia. Am Surg 2016;82:E18-19.
22.
Kasirajan K, Lopez J, Lopez R: Laparoscopic technique in the management of Spigelian hernia. J Laparoendosc Adv Surg Tech A 1997;7:385-388.
23.
Yau KK, Siu WT, Chan KL, Li KW: A man with recurrent lower abdominal pain: Spigelian hernia. Surg Laparosc Endosc Percutan Tech 2008;18:106-108.
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