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Case Report
Laparoscopic repair for a recurrent epigastric incisional hernia following xiphoidectomy: A case report
1 Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
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Sanjna Gangakhedkar
Division of Surgery, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW 2305,
Australia
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Article ID: 100138Z12SG2024
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How to cite this article
Gangakhedkar S, Francis G, Holmes M, Wright T. Laparoscopic repair for a recurrent epigastric incisional hernia following xiphoidectomy: A case report. J Case Rep Images Surg 2024;10(1):48–51.ABSTRACT
Introduction: Xiphodynia is a rare musculoskeletal disorder characterized by epigastric or anterior chest pain, for which xiphoidectomy is considered as a definitive treatment. This procedure and its complications are not well researched, particularly within Australasian populations. We describe the novel laparoscopic incisional hernia repair from a xiphoidectomy complicated by recurrent epigastric hernias.
Case Report: A 49-year-old female presented with chronic epigastric pain post-xiphoidectomy for xiphoidynia. The patient previously underwent open mesh repair for an incisional epigastric hernia, complicated by infection and subsequent removal of the mesh. A vacuum-assisted closure device was then utilized, followed by delayed primary closure. However, she experienced ongoing pain, a recurrent mass, and hypertrophic scarring, confirmed by abdominal computed tomography (CT) scan. Our laparoscopic approach involved a standard supine position with three ports and preperitoneal dissection similar to transabdominal preperitoneal (TAPP) hernia repair. The defect was 5 × 8 cm in size. A simple prolene mesh (9 × 12 cm) was secured with AsorbaTack and Glubran 2, followed by peritoneal closure with a 3/0 V-Loc suture. At two months follow-up, the patient had no evidence of recurrent hernia, no ongoing pain, and satisfactory wound healing.
Conclusion: Laparoscopic surgical repair using a TAPP approach is a safe alternative to open repair of an incisional recurrent epigastric hernia post-xiphoidectomy.
Keywords: Epigastric hernia, Laparoscopic epigastric hernia repair, Laparoscopic incisional hernia repair, Xiphodynia, Xiphoidectomy
SUPPORTING INFORMATION
Author Contributions
Sanjna Gangakhedkar - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Gabrielle Francis - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Merran Holmes - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Timothy Wright - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Addis Y Kidane - Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Sanjna Gangakhedkar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
