Lumbar hernia is a rare condition with fewer than 300 cases reported in the literature. The region of the upper lumbar triangle of grynfeltt, is the site affected most often, followed by the lower lumbar triangle of petit. The clinical anatomy of the triangle of grynfeltt springerlink. The hernia was approached through a tranverse incision over the left lumbar region. The muchanticipated revision of the second edition of the sages manual. The superior lumbar triangle of grynfeltlesshaft is bounded superiorly by the. In 1870, lesshaft independently reported a similar case. More frequently lumbar hernia is unilateral, twice frequent on the left and in patients between the 5 th and 7 th decades of life 1,6,7. This page was last edited on 27 december 2019, at 19. Pdf lumbar hernias develop through the weakening of the posterolateral abdominal wall associated with the petits triangle or the. Petit, in 1783, 1 and grynfeltt in 1866, 2 described the. This book provides an overview of the current understanding. Retroperitoneoscopic tensionfree repair of lumbar hernia. All structured data from the file and property namespaces is available under the creative commons cc0 license.
Cleveland clinic, cleveland, ohio purpose a very simple laparoscopic technique to repair a superior lumbar hernia is described. Cutting points or edges must be sharp and free of burrs. An acquired grynfeltt lumbar hernia can be complicated by in. Wrapping the visceral sac into a bilateral mesh prosthesis in groin. Underlay mesh repair for spontaneous lumbar hernia sciencedirect. Lumbar hernia account for less than 2% of al abdominal hernias, been the grynfeltlesshafts hernia glh more frequent than the others. Lumbar hernia is a quite unusual lesion which corresponds to 2% of all abdominal wall hernias. The triangle was studied in 50 adult human cadavers, and dimensions and surface area were measured. Intra operatively content of the hernia was found to be retroperitonal fat. It was a case of primary acquired lumbar hernia in the superior. Due to the rarity of grynfelt hernia, there is no standardized surgical technique.
Few reports have been published in the literature describing primary lumbar hernia. Elective surgery was performed, and the results revealed petits hernia. Laparoscopic tapp repair of grynfeltt hernia sages. Grynfelt hernia produces in 23 of cases in males with or without.
The antimesenteric border of the intestine must protrude into the hernia sac the most common location is at the site of a femoral hernia. Feb 07, 2005 grynfeltts hernia grynfeltts hernia prietodiazchavez, e medinachavez, j prietodiaz, s. This chapter discusses less common hernias of the abdominal wall and pelvis, which rarely come to the attention of a general surgeon. The lumbar triangle can refer to either the inferior lumbar petit triangle, which lies superficially, or the superior lumbar grynfeltt triangle, which is deep and. Such hernias may manifest within the superior lumbar triangle of grynfeltt tg or the triangle of petit. Endoscopic retroperitoneal repair of a grynfelt hernia. On most atraloc needles, a supersmooth finish is provided that permits the needle to penetrate and pass through with minimal resistance or drag.
Download farquharsons textbook of operative general surgery 10th edition pdf free file size. Current principles will be an invaluable resource to all residents and practicing general, plastic, and trauma surgeons to help them succeed in the field of hernia surgery. A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the. Pdf abstract this report describes an alternative technique for petit hernia repair. Hernia surgery ebook by 9783319274706 rakuten kobo. The triangle was studied in 50 adult human cadavers, and dimensions and surface area were. Of the two, the superior triangle is the more consistently found in cadavers, and is more commonly the site of herniation. The grynfelttlesshaft hernia is a rare posterior abdominal wall defect that allows for the. Lumbar hernia is the protrusion of intraperitoneal or extraperitoneal contents through a defect of the abdominal wall. The processus vaginalis must be patent for this type of hernia to occur.
The aim of our study was to identify and describe variations in the size and anatomy of the tg. Marcy repair called simple ring closure it consists of tightening an enlarged deep ring only is indicated in men and women who have indirect hernia with only minimal damage to the deep ring is the hernioplasty of choice for women with indirect inguinal hernia after dividing the round ligament and eliminating the sac, the deep ring is abolished. Hernia protrusion of visceral contents through the abdominal wall. The most common location is the top of lumbar triangle, probably reflecting the fragility of this area, where the botton is just the transversal fascia. Grynfeltt described a hernia through the superior lumbar triangle in 1866 grynfeltt, 1866. Ribbed needles longitudinal ribs are provided on many atraloc needles to increase the stability of the needle in the needleholder. Files are available under licenses specified on their description page. These mesh repair methods are often called tension free repairs because, unlike. These include hernias of the lumbar triangles in the lower back, namely the superior lumbar hernia or grynfelt lesshaft hernia and inferior lumbar hernia or petit hernia. Petits hernia is a hernia that protrudes through the lumbar triangle.
We report a case of lumbar hernia in a middleaged woman. Meckel diverticulum as the sole component of the hernia sac. All books are in clear copy here, and all files are secure so dont worry about it. Laparoscopic tapp repair of grynfeltt hernia sages abstract. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in hisher lifetime. Dorsal lumbar hernias are rare pathologies of the abdominal wall. Method the case of an 67yearold patient with a symptomatic grynfeltt lumbar hernia is reported. Pdf petit lumbar herniaa doublelayer technique for tension. Grynfelttlesshaft hernia is a herniation of abdominal contents through the back, specifically through the superior lumbar triangle, which is defined by the quadratus lumborum muscle, twelfth rib, and internal oblique muscle history. As a comprehensive and most uptodate reference to modern treatment algorithms, trends in prosthetic science and technique selections, hernia surgery. From april 2010 to september 2017, 12 cases of primary superior lumbar hernia grynfelt hernia were identified through medical records.
It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Lumbar, pelvic, and uncommon hernias sciencedirect. There were two defects noted in the region of the superior triangle of 3. This triangle lies in the posterolateral abdominal wall and is bounded anteriorly by the free margin of external oblique muscle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. The superior lumbar triangle, also known as the grynfelttlesshaft triangle, is bordered by the 12th rib and posterior inferior serratus muscle.
Scribd is the worlds largest social reading and publishing site. Download as ppt, pdf, txt or read online from scribd. Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Fundamentals of laparoscopy, thoracoscopy, and gi endoscopy, has been completely restructured, reorganized, and revised. Laparoscopic hernia surgery top results of your surfing laparoscopic hernia surgery start download portable document format pdf and ebooks electronic books free online rating news 20162017 is books that can provide inspiration, insight, knowledge to the reader. The patient was a 64yearold male with a right lumbar mass of 5. Petit, in 1783, 1 and grynfeltt in 1866, 2 described the lower and the upper lumbar hernias respectively. Local and regional anesthesia with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, 14598297030. Back lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy congenital. Indirect inguinal hernia an indirect inguinal hernia occurs when any intraabdominal structure protrudes through the deep inguinal ring entering the inguinal canal. Abd wall hernias university of tennessee college of medicine. The diagnosis was made by physical examination and confirmed by computed tomography scan. Netters surgical anatomy and approaches download pdf free. The term hernia is derived from the greek word hernios, which means budding.
An indirect inguinal hernia is a congenital lesion. Pitfalls and clinical recommendations for the primary lumbar hernia. This file is licensed under the creative commons attributionshare alike 3. The grynfelttlesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro and intraperitoneal structures through the upper lumbar triangle. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses. Download farquharsons textbook of operative general. The manual has been split into two volumes for better portability. Laparoscopic inferior and superior lumbar hernia repair. Download netters surgical anatomy and approaches pdf free. Minilaparoscopic treatment of a grynfeltt lumbar hernia.
Grynfeltts hernia grynfeltts hernia prietodiazchavez, e medinachavez, j prietodiaz, s. The lumbar triangle can refer to either the inferior lumbar petit triangle, which lies superficially, or the superior lumbar grynfeltt triangle, which is deep and superior to the inferior triangle. From april 2010 to september 2017, 12 cases of primary superior lumbar hernia grynfelt hernia were identified. Grynfelttlesshaft hernia is a herniation of abdominal contents through the back, specifically through the superior lumbar triangle, which is defined by the quadratus lumborum muscle, twelfth rib, and internal oblique muscle. Ebook laparoscopic hernia surgery as pdf download portable. S assistant professor, dept of general surgery, psgimsr.