Robotic Repair of an Acquired Abdominal Intercostal Hernia

Daniel Bergholz, BA, J. Ryan Obi, MD, Robert Grossman, MD, Taha F. Rasul, BS

Department of Surgery, University of Miami Miller School of Medicine (D. Bergholz, T. F. Rasul)

NCH Baker Hospital, Naples (J. R. Obi, R. Grossman)

Introduction: Intercostal hernias are a rare clinical entity. They are divided into trans-diaphragmatic intercostal or abdominal intercostal hernias based upon the presence or absence of diaphragmatic injury. There are various means of repair for these hernias, including open, laparoscopic, and robotic approaches. We present the second known robotic repair of an abdominal intercostal hernia and review of the relevant literature.

Case Description: A 54-year-old morbidly obese male was found to have an abdominal intercostal hernia on the right between the 9th and 10th ribs. His symptoms were significant for a large, tender right chest wall mass. Through a three-port approach, polypropylene mesh and circumferential sutures were used to create a double-wall of reinforcement to secure the area of weakness.

Discussion: This rare case of an intercostal hernia utilized robotic-assisted laparoscopic repair and led to a favorable outcome, whereby the patient reported significant improvement in pain, comfort, and quality of life. Thus, minimally invasive robotic surgery for this complex structural pathology can be safer and have less complications than other current treatments.

Key Words: Intercostal, Hernia, Robotic, Laparoscopic, Abdominal.

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