Hernia de Spiegel enfoques actualizados de diagnóstico y abordaje quirúrgico

Abstract

Introduction: A hernia is defined as a protrusion or bulge of an organ or tissue through the abdominal wall. In particular, Spigelian hernia represents bet ween 0.1% and 2% of all hernias. Indeed, it is considered a rare disorder for which little evidence is available. Objective: To carry out a review of the updated bibliography about Spigelian hernia, diagnosis and its surgical approach. Materials and methods: To locate the bibliographic documents, several documentary sources were reviewed, considering repositories and medical journals. 32 articles of the most current evidence available on the subject, published in the last 5 years in journals with a high im pact factor and scientific rigor, were included. Results: Spigelian hernia is located in the group of primary ventral hernias, which is located in the Spigelian fascia. It has been described that it forms from the transition between the muscle and aponeurosis of the transversus abdominis. The contents of the hernial sac range from fat to viscera. 50% of patients are asymptomatic and discovered incidentally. Ultrasound is the imaging technique that allows the defect to be clearly identified. The recommended repair is laparoscopic with closure of the defect and placement of mesh. Complications are im prisonment and strangulation, occurring in 15% to 25 % of cases. Conclusion: Spigelian hernia is a little-known defect, with barely 1,000 reports worldwide in adults and 50 in children. Recommendations of the European Hernia Society for the use of mesh, regardless of the technique, are evidenced. Spigelian hernia is an underdiagnosed disorder. It is diagnosed by ultrasound and its preferred approach is minimally invasive