Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4228-4233
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4228
Mine disaster survivor’s pelvic floor hernia treated with laparoscopic surgery and a perineal approach: A case report
Kai Chen, Yuan-Zhi Lan, Jing Li, Yuan-Yuan Xiang, Dong-Zhu Zeng
Kai Chen, Yuan-Zhi Lan, Jing Li, Yuan-Yuan Xiang, Dong-Zhu Zeng, Department of General Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
Author contributions: Chen K wrote the paper; Lan YZ, Li J and Xiang YY collected the data and relevant images; Zeng DZ revised the paper.
Informed consent statement: Informed consent was obtained before any medical investigation or initiation of treatment as required.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Dong-Zhu Zeng, MD, PhD, Chairman, Professor, Department of General Surgery, The Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Branch Road, Yubei District, Chongqing 401120, China. 650777@hospital.cqmu.edu.cn
Received: June 22, 2020
Peer-review started: June 22, 2020
First decision: July 24, 2020
Revised: July 28, 2020
Accepted: August 20, 2020
Article in press: August 20, 2020
Published online: September 26, 2020
Abstract
BACKGROUND

A pelvic floor hernia is defined as a pelvic floor defect through which the intraabdominal viscera may protrude. It is an infrequent complication following abdominoperineal surgeries. This type of hernia requires surgical repair by conventional or reconstructive techniques. The main treatments could be transabdominal, transperineal or a combination.

CASE SUMMARY

In this article, we present the case of a recurrent perineal incisional hernia, postresection of the left side of the pelvis, testis and lower limbs resulting from a mine disaster 18 years ago. Combined laparoscopic surgery with a perineal approach was performed. The pelvic floor defect was repaired by a biological mesh and one pedicle skin flap. No signs of recurrence were indicated during the 2 years of follow-up.

CONCLUSION

The combination of laparoscopic surgery with a perineal approach was effective. The use of the biological mesh and pedicle skin flap to restructure the pelvic floor was effective.

Keywords: Case report, Pelvic floor hernia, Hernioplasty, Biological mesh, Laparoscopic surgery, Perineal approach

Core Tip: The combination of laparoscopic surgery with a perineal approach for complicated pelvic floor hernias could be a better way to improve the safety and effectiveness of surgery. The application of the biological mesh and flaps is safe and effective with a good long-term outcome. Hernioplasty of the pelvic floor hernia via an associated pathway is technically feasible, is associated with rapid recovery and minimal complications and has a good long-term outcome. The use of a biological mesh and flaps to repair the defect likely improves results, especially for patients with a larger pelvic floor hernia or the possibility of severe adhesion and potential infection.