Journal of Personalized Medicine · 8 authors, 2 centres
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This technical note describes a step-by-step surgical technique for perineal hernia repair using only the perineal approach with synthetic polypropylene mesh in patients who previously underwent abdominoperineal resection for rectal cancer. All five patients in the series had their perineal hernia successfully resolved surgically.
This technical note describes a surgical technique for perineal hernia (PH) repair performed exclusively via the perineal approach using synthetic polypropylene mesh. Five patients were admitted with PH over three years following abdominoperineal resection (APR) for rectal cancer; two cases are presented with intraoperative photographs and CT scans. The authors describe a step-by-step perineal mesh placement technique, arguing it offers better recovery than combined approaches. The discussion contextualizes the technique within the broader literature, noting that primary closure carries a documented recurrence rate of 50% compared to 20% with mesh, and that the BIOPEX trial found 87% freedom from perineal hernia at 1 year with biological mesh versus 73% with primary closure. The authors acknowledge that the optimal surgical approach and mesh type remain controversial due to low PH incidence and a lack of randomized trials comparing perineal versus abdominal approaches.
