# Laparoscopic repair for Spigelian-inguinal hernia complex: A case report and review of literature

## TL;DR

This paper presents a new laparoscopic technique for repairing a rare type of hernia that occurs near the abdominal wall and groin, showing it is safe and effective.

## Contribution

The first report of a modified TAPE technique for repairing a Spigelian-inguinal hernia complex.

## Key findings

- The modified TAPE technique achieved 100% early success in the case presented.
- The hybrid approach reduces recurrence rates and hospital stays compared to open surgery.
- The technique avoids mesh-related complications by using preperitoneal mesh and peritoneal flap closure.

## Abstract

Spigelian hernia, a rare primary abdominal wall defect accounting for 2 % of all hernias, poses diagnostic challenges due to its anatomical proximity to the semilunar line. Its coexistence with inguinal hernia further complicates management. This report introduces an innovative laparoscopic approach for concurrent Spigelian-inguinal hernia repair.

A patient presented with left lower abdominal and inguinal pain. CT revealed a 4-cm Spigelian hernia ring. We performed the modified TAPE technique combining TAPP and IPOM principles: The hernia sac was reduced transabdominally, followed by preperitoneal mesh placement with peritoneal flap closure. Postoperative recovery was uneventful, with discharge on day 3. Three-month follow-up confirmed durable repair without complications.

Spigelian hernia carries higher incarceration risks due to narrow fascial defects. While imaging advances improve detection rates, 30–50 % are initially misdiagnosed. Our modified TAPE technique addresses dual challenges: 1) Preperitoneal mesh placement avoids visceral contact seen in IPOM; 2) Peritoneal flap closure prevents mesh migration. Comparative studies show laparoscopic approaches reduce recurrence rates (1.2 % vs 4.7 % open) with shorter hospital stays.

This case validates the modified TAPE technique as a safe, effective solution for Spigelian-inguinal hernia complex. The hybrid approach leverages laparoscopic advantages while mitigating traditional limitations, demonstrating 100 % early success in our series. This strategy warrants broader application in specialized hernia centers.

•First report of modified TAPE for Spigelian-inguinal hernia complex repair•Safety and feasibility of modified TAPE procedure are demonstrated.•Summarizes clinical manifestations, diagnosis, and treatment for Spigelian hernia•Provides new insights for clinical management of Spigelian hernia

First report of modified TAPE for Spigelian-inguinal hernia complex repair

Safety and feasibility of modified TAPE procedure are demonstrated.

Summarizes clinical manifestations, diagnosis, and treatment for Spigelian hernia

Provides new insights for clinical management of Spigelian hernia