Large Incisional Hernia Following Bone Grafting Surgery.

Comments: This 70 year lady came to us with complain of swelling left iliac fossa for 3 years. She underwent bone grafting surgery for her spinal injury 4 years back , where left iliac crest bone graft taken . Here you can see a large swelling of size around 15 cm x 12 cm in left iliac fossa. The swelling becomes prominent with each bout of coughing or by standing. The swelling can be reducible manually. After complete reduction of contents of hernia, the hernia defect can be well felt. One can feel the big hollow of defect where the fingers can be insinuated easily .one can see the deficiency of bone in iliac fossa because of lack of iliac crest bone as it was removed in previous surgery. In this case surgery is the definitive treatment. Here open hernioplasty is required. The hernia defect to be closed with a polypropylene mesh. Laparoscopic hernioplasty cannot be done as it is not feasible to fix the mesh intra peritoneal ly as there is no support to fix the mesh internally.