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Lateral Hernias
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Probably the rarest of the abdominal wall hernias, they were proposed as a possibility by Barette in 1672 and physically described by de Garengeot in 1731, since when between 350 and 400 have been categorized.1 They herniate through either the superior or inferior lumbar triangles which were described in the eighteenth and nineteenth centuries, or more diffusely throughout the lumbar area without respect to either defined anatomical area. The superior lumbar triangle (of Grynfeltt-Lesshaft) was described in 1866 and is bordered above by the 12th rib, anterolaterally by the internal oblique muscle and posteromedially by quadratus lumborum and sacrospinalis muscles. The floor of the transversalis fascia and aponeurosis of the transversus abdominis muscle is penetrated by the neurovascular bundle of the 12th dorsal intercostal nerve forming a potential weakness, and the triangle is roofed by the latissimus dorsi and external oblique muscles. The inferior triangle (of Petit) is smaller and bounded by the external oblique laterally, latissimus dorsi medially and iliac crest inferiorly – its floor is the lumbodorsal fascia and is said to not be penetrated by any neurovascular bundles (Figure 15.1a–c).
The male reproductive system and hernias
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Rare types of abdominal wall hernia (Fig. 8.8) include: Obturator hernia – through the obturator foramen.Spigelian hernia – through the lower part of the sheath of the rectus abdominis muscle (which is deficient posteriorly).Lumbar hernia – through the inferior lumbar triangle.Gluteal hernia – through the greater sciatic notch.
Abdominal wall, hernia and umbilicus
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Most primary lumbar hernias occur through the inferior lumbar triangle of Petit bounded below by the crest of the ilium, laterally by the external oblique muscle and medially by latissimus dorsi (Figure60.29). Less commonly, the sac comes through the superior lumbar triangle, which is bounded by the twelfth rib above, medially by sacrospinalis and laterally by the posterior border of the internal oblique muscle. Primary lumbar hernias are rare, but may be mimicked by incisional hernias arising through flank incisions for renal operations, or through incisions for bone grafts harvested from the iliac crest.
Minimally invasive repair of a lumbar hernia utilizing the subcutaneous space only
Published in Baylor University Medical Center Proceedings, 2019
Jessica S. Clothier, Marc A. Ward, Ahmed Ebrahim, Steven G. Leeds
Approximately 25% of the population will develop a ventral hernia in their lifetime. Hernia repair is one of the most common procedures for a general surgeon and costs billions of dollars to the health care system.1 In particular, lumbar hernias commonly present as a palpable flank mass that increases in size with strenuous activity and/or intra-abdominal pressure.2 These hernias protrude through weakened areas in the posterior-lateral abdominal wall at the superior or inferior lumbar triangles, resulting in Grynfeltt or Petit hernias, respectively.3 Studies favor the use of minimally invasive techniques such as laparoscopy for nonmidline ventral hernias over open procedures4,5; however, the application of a purely subcutaneous approach for lumbar hernia that completely bypasses the peritoneal or retroperitoneal space is seldom reported. Here we look at a case of endoscopic lumbar hernia repair.
Evaluation of transversus abdominis plane (TAP) block in lipoabdominoplasty surgical procedure: a comparative study
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Nawaf Naif Alotaibi, Tawheed Ahmad, Sari Monzer Rabah, Aljohara Mohmoud Hamza, Sheikh Mohammad Tafazul
The mid-abdominal approach for TAP block was introduced in 2012, in which TAP block is administered under the ultrasound guidance [13]. This technique involves administration of local anaesthetic medication 5 to 8 cm lateral to the umbilicus and hence reliably blocks the T9 through L1 dermatomes; in addition this technique is easily reproducible and more effective as well. We adopted ultrasound guided TAP block in our study as it best combines the blockade effect of both subcostal approach as well as of the petit lumbar triangle approach.