Video. Laparoscopic lumbar hernia repair with bone anchor fixation.
The anatomic features of lumbar hernias create several challenges. A number of surgical approaches for lumbar hernia repair have been described, including laparoscopic and open methods as well as intraperitoneal and preperitoneal approaches and the use of flaps to cover the defects. However, limited fixation points for the mesh can lead to high recurrence rates. Bone anchors have been used in a variety of surgical disciplines, including orthopedics, plastic surgery, and gynecologic surgery, with low complication rates of bone pain or infection. We demonstrated a method that utilizes bone anchor fixation in a laparoscopic approach to overcome the challenge of inferior fixation. This securely repairs the hernia with good coverage of the defect while maintaining the benefits of the minimally invasive approach.