Successful repair of a Grynfeltt-Lesshaft hernia with the PROCEED™ VENTRAL PATCH

We present the case of a 53 year old patient with a history of mental disability and pronounced scoliosis, who presented to our emergency department with a Grynfeltt-Lesshaft hernia with protrusion of the ascending colon and the right ureter.

The hernia was repaired via a dorsal, extraperitoneal approach. The patient was placed in a left lateral position. A dorsal incision of 6 cm between the 12^th rib and iliac crest was made. The hernia sack was dissected and reduced. The superior lumbar triangle with the bordering structures was visualized The hernia gap with a diameter of approximately 1 cm was closed with insertion of a 6.4 × 6.4 cm PROCEED™ VENTRAL PATCH (Ethicon, Norderstedt, Germany). The operating time was 33 minutes and the patient was discharged the next day and showed no signs of recurrence at one-month follow up.

Up until now there is no retrospective study or randomized controlled trial analyzing the results of the different surgical techniques for closure of a primary lumbar hernia. The technique described here is favorable because it requires very little dissection of the surrounding tissue and no trans-/intraabdominal dissection. Thus it results in a very fast postoperative recovery. Therefore we suggest considering this operative technique for closures of primary lumbar hernias.

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