When is the transgluteal approach indicated in the surgical repair of an abdominal sciatic hernia?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

A transgluteal repair can be used if the diagnosis is established and the intestine is clearly viable. The patient is placed prone, and the incision is extended from the hernia toward the greater trochanter. The fibers of the gluteus maximus are spread to expose the piriformis, the gluteal neurovascular bundle, and the sciatic nerve. A prosthetic patch closes the defect between the piriformis and the iliac or ischial bone.


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