PMC9979863_01
CT scan of the abdomen and pelvis without contrast, which displays a periumbilical incisional hernia (dotted arrow) and a left-sided Spigelian hernia (plain arrow).
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FIG1
Upon further investigation with CT imaging, a 3.5 cm left-sided Spigelian hernia and a 3 cm periumbilical incisional hernia were identified, as seen in Figure 1.
Fat removal from periumbilical defect.
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FIG2
This left the preperitoneal space with an opening, as seen in Figure 2.
GORE  SYNECOR hybrid composite mesh sutured over periumbilical defect intraperitoneally.
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FIG3
Subsequently, the periumbilical incisional hernia defect was closed intraperitoneally with 0 V-Loc sutures and a 12 cm circle GORE  SYNECOR hybrid composite mesh, as seen in Figure 3.
Synthetic absorbable mesh sutured over Spigelian defect preperitoneally.
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FIG4
Next, the left-sided Spigelian hernia defect was closed preperitoneally with 0 V-Loc sutures and a 9 cm preperitoneal synthetic absorbable mesh, as seen in Figure 4.