Laparoscopic repair of an anterior perineal hernia: a video presentation

BACKGROUND: The perineal hernia is a condition that occurs as a result of a defect in the pelvic diaphragm. It is classified as anterior or posterior, and as either a primary or secondary hernia. The best management of this condition remains controversial. OBJECTIVES: To demonstrate the surgical steps of a laparoscopic repair with mesh of a perineal hernia. MATERIALS AND METHODS: A video presentation showing the laparoscopic repair of a recurrent perineal hernia MAIN OUTCOME MEASURES: A 46-year-old woman with a prior history of a primary perineal hernia repair had complaints of a symptomatic vulvar bulge. Pelvic magnetic resonance imaging showed a 5 cm hernia sac at the right anterior pelvic wall containing adipose tissue. A laparoscopic perineal hernia repair was performed by dissection of the space of Retzius, reduction of the hernial sac, closure of the defect and mesh fixation. RESULTS: The laparoscopic repair with mesh of a recurrent perineal hernia is demonstrated. CONCLUSION: We showed that the laparoscopic approach can be an effective and reproducible treatment for perineal hernia. LEARNING OBJECTIVE: Understanding of the surgical steps involved in the laparoscopic repair with mesh of a recurrent perineal hernia.