Hypothesis: The elective treatment of a spigelian hernia is still under discussion, fundamentally owing to its rarity. The purpose of the study is to analyze the elective surgical treatment of spigelian hernia.

Design: A prospective, randomized controlled trial.

Setting: University teaching hospital.

Patients And Interventions: Two surgeons performed 11 conventional and 11 laparoscopic repairs for a spigelian hernia, alternating roles as primary surgeon and assistant. Each time the type of technique was randomly chosen using a computerized program.

Main Outcome Measures: Epidemiological, clinical, and surgical factors are analyzed according to treatment, ie, the open or laparoscopic approach.

Results: The statistical study shows no significant differences for epidemiological or diagnostic factors, but it does show significant advantages for laparoscopy in terms of morbidity (P<.05) and hospital stay (P<.001).

Conclusion: The approach using extraperitoneal laparoscopy is the technique that offers best results in the elective treatment of spigelian hernia.

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http://dx.doi.org/10.1001/archsurg.137.11.1266DOI Listing

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