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Abstract Aim Spigelian hernia, a very rare form of anterior parietal defect (incidence reaching maximum 0.12–2% of abdominal wall hernias), occurs at the semilunar line or Spigelian line. In most cases, it is a small hernia defect, measuring 2 cm in diameter. With ambiguous symptoms and often no clinical findings, this hernia is diagnosed usually in the complication stages (the incarceration rate reaches up to 27%). This is why no “watchful waiting” approach is recommended and it should be operated upon even if the patient is asymptomatic. Material and Methods A 32-year-old female patient with incarcerated Spigelian hernia, presented to our clinic with pain in the left iliac fossa. The clinical examination revealed a small, irreducible swelling at the level of the left semilunar line. CT (computed tomography) examination described a 5 mm parietal defect – compatible with a left infraumbilical Spigelian hernia, in which the left adnexa was incarcerated. Results A laparoscopic TAPP approach was chosen, practicing the reduction of the herniated content (left adnexa of normal macroscopic appearance) and the placement of an 11/8 cm synthetic mesh at the preperitoneal level. After surgery, the patient was discharged safety on the second postoperative day, with favorable evolution, quick post-operative recovery, no surgical site infection, no postoperative complications and a good aesthetic outcome. Conclusion In conclusion, we want to highlight the importance of knowing rare pathologies such as Spigelian hernia and their high complication rate, as well as the benefits of minimally invasive treatment.
Florea et al. (Wed,) studied this question.