However, a number of patients present with no obvious symptoms but vague tenderness along the area in which the Spigelian fascia is located. Diagnosis
Ultrasound Imaging or a CT Scan will provide better imaging for the detection of a hernia than an xray. The ultrasound probe should move from lateral to medially, a hypoechoic mass should appear anteriorly and medially to the inferior epigastric artery during Valsalva maneuver. The diagnosis of a Spigelian hernia is traditionally difficult if only given a history and physical examination. People who are good candidates for elective Spigelian hernia surgery, not only but also, after receiving an initial diagnostic consultation by a licensed medical professional, will be advised to see a physician to schedule surgery. Treatment
The Spigelian hernia can be repaired by either an open procedure or laproscopic surgery because of the high risk of strangulation; surgery is straightforward, with only larger defects requiring a mesh prosthesis. In contrast to the laparoscopic intraperitoneal onlay mesh plan of action there is a significant higher risk associated with complications and recurrence rates during the period following a surgical operation. A Spigelian hernia becomes immediately operative once the risk of incarceration is confirmed. Today, a Spigelian hernia can be repaired by doing robotic laparoscopy and most patients can go home the same day. This novel uncomplicated approach to small Spigelian hernias combines the benefits of laparoscopic localization, reduction, and closure without the morbidity and cost associated with foreign material.
Mesh-free laparoscopic suture repair is an uncomplicated approach to small Spigelian hernias combined with the benefits of a closure without the anguish and cost associated with foreign material. Eponym
Adriaan van den Spiegel, born in Brussels, was an anatomist at the University of Padua during the 17th century. In 1619 he became a professor of surgery. Spiegel was the first to described this rare hernia in 1627. The history of the Spigelian hernia became acknowledged in 1645, twenty years after Spiegels death. In 1764, almost a century later, the Flemish anatomist, Josef Klinkosch was acknowledged for recognizing and describing a hernia located in the Spigelian fascia, and coined the term Spigelian hernia. Raveenthiran syndrome
Raveenthiran described a new syndrome in which Spigelian hernia and cryptorchidism (undescended testis) occur together. Some common complications of this distinct syndrome cryptorchidism are testicular torsion, and its link to testicular cancer. References
External links
Adriaan van den Spiegel at Who Named It? Laparoscopic Repair of Spigelian Hernia Medtube