Laparoscopic Repair of Perineal Hernia Using a Double-Mesh Technique

Introduction: Perineal herniation following pelvic surgery, including abdomino-perineal resection (APR) and pelvic exenteration is a rare condition but can present with serious complications. Multiple methods of repair are possible including either an abdominal or perineal approach. Laparoscopic abdominal repairs have been described. Case Presentation: An 83 year-old lady, under follow-up following a laparoscopic APR two years previously for a T2N0M0 low rectal cancer, presented with a symptomatic perineal hernia which caused significant impairment in her daily living activities. She had no major comorbidities and was keen for intervention. She was electively admitted for a laparoscopic repair of perineal hernia. This was performed using a double-mesh technique, which allows strengthening of the repair as a feasible alternative to consider in repair of this difficult complication. Conclusions: This technique is feasible as an alternative to standard laparoscopic or perineal repair of perineal herniation. Further studies are required to demonstrate its long-term efficacy.