Laparoscopic Repair of a Subxiphoid Hernia After Omental Flap Reconstruction

Stephenie Poris, MD, Lauren Goldberg, MD, Jean Miner, MD

Center for Specialized Surgery, Florida Hospital, Orlando, Florida (all authors).

ABSTRACT

Introduction: Hernias anterior to the sternum have rarely been reported and usually occur in the context of abdominal trauma. The literature reports hernia as a complication of omental flap reconstruction, but as yet there is little information on the laparoscopic repair of large subxiphoid hernia resulting from omental flap reconstruction.

Case: A 52-year-old woman presented 2 years after surgery with a large subxiphoid hernia containing the transverse colon. She had a history of metastatic follicular dendritic cell sarcoma after right lung lobectomy that led to infectious mediastinitis and a nonhealing sternal wound, for which she underwent omental flap repair.

Discussion: Our findings show the omentum can be reliably utilized to reconstruct thoracic defects. It can be a dependable salvage flap for previously failed reconstructions and can be transected in the face of a laparoscopic repair of a subxiphoid hernia. Furthermore, minimally invasive laparoscopic surgery provides a safe and effective surgical approach in a complicated patient with a subxiphoid hernia.

Key Words: Anterior wall reconstruction, Minimally invasive hernia repair, Omental flap, Subxiphoid hernia

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