Lumbar Hernia, a Big Unknown. Case Series on an Experienced Abdominal Wall Unit

Aim Primary lumbar hernia or lumbar incisional hernia (LIH) is a rare pathology. It can cause serious quality of life problems or complications such as intestinal obstruction. Its management is complex, conservative treatment is being recommended in many centers. The objective is to describe our series of lumbar hernias/LIH. Material and Methods LIH and primary lumbar hernias operated by during 2019–2023. We have analyzed demographic and intervention-related data. The minimum follow-up has been 8 and the maximum 50 months. Morbimortality (Clavien Dindo classification), reinterventions and recurrences have been analyzed. Results 100% of primary lumbar hernias and LHI seen in the out patient clinic were operated (8 patients). Demographic and intervention-related characteristics are described in Table 1.Aetiology Primary1 (12.5%) LHI7 (87.5%)Medium BMI (kg/m2)33.1 +/- 7.1Medium CeDAR (%)29.8 +/- 19Gender Male5 (62.5%) Female3 (37.5%)Medium age (years)54.6 +/- 17.6Prehabilitation Botulinum toxina3 (37.5%) Progressive pneumoperitoneum1 (12.5%)Clasification L47 (87.5%) M1M2M3L41 (12.5%) W26 (75%) W32 (25%)Surgical technique Preperitoneal5 (62.5%) HemiTAR2 (25%) Carbonell1 (12.5%)Medium stage (days)6.3 +/-4.3Complications I (haematoma)1 (12.5%) II (superficial surgical site infection)2 (25%) Polypropylene meshes were used in all patients, 3 cases a long-term resorbable biosynthetic mesh was added. No reinterventions or recurrences have been recorded. Conclusions According to our results, repair with large meshes has a low rate of complications and no recurrences, which is why we recommend the intervention in experienced units.