Tapp Approach for Incisional Lumbar Hernia. A Video Presentation

Introduction Lumbar incisional hernias (LIH) constitute infrequent abdominal wall defects, typically arising as a consequence of traumatologic procedures. The surgical approach to LIH can be challenging due to the absence of specific recommendations for this particular condition. Methods This study presents a case report of a LIH resulting from lumbar arthroplasty in a 49-year-old female patient with no prior medical history. The patient reported back pain, and a CT scan revealed a lumbar hernia in close proximity to the iliac bone. Results A transabdominal preperitoneal approach (TAPP) was employed, uncovering a lumbar defect measuring 6 × 6 cm with a hernia sac containing the left colon. Procedures included peritoneal sac reduction, defect closure near the iliac bone, and placement of a polypropylene mesh in the preperitoneal position. Conclusion The TAPP approach proves to be a viable surgical technique for addressing LIH. It is crucial to acknowledge that closing the hernia defect may pose challenges when the hernia edges involve bony structures.