Spigelian hernias: A high volume institutional review

PURPOSE: The objective of this study was to evaluate a high-volume hernia center's experience with primary Spigelian hernias. INTRODUCTION: Spigelian hernias are rare entities presenting a diagnostic dilemma for clinicians that often lead to a delay in treatment or need for emergency surgery. Given this low incidence true patient and hernia characteristics are unknown. METHODS: This was a retrospective chart review evaluating patients who underwent a Spigelian hernia repair between 2005 and 2019. Descriptive statistics were utilized. RESULTS: The incidence of Spigelian hernias at our institution was 0.14 %. There were 141 patients with 143 spigelian hernias (two patients had bilateral hernias) repaired at our institution during the study period, the majority of these were in male patients, left sided and repaired under conscious sedation with or without the use of mesh. CONCLUSION: This study adds a large dataset to the paucity of literature that exists in the context of Spigelian hernias and alerts the clinician that these hernias are not exclusive to the older female population. Furthermore, this study provides the need for a high index of suspicion in patients presenting with vague abdominal pain who may not fit the typical Spigelian hernia mold.