PMC5664275_01
Hernia arising from the lumbar region just below the twelfth rib on the right side.
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fig1
Physical examination revealed a bulge arising below the twelfth rib (Figure 1).
Retroperitoneal fat dissected out up to the defect.
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fig2
The retroperitoneal fat constituted the hernia (Figure 2).
Defect delineated after excision of the protruding retroperitoneal fat.
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fig3
The defect was clearly appreciated and delineated (Figure 3).
Fascial flaps sutured over the defect.
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fig4
The fascia was approximated with interrupted Prolene stitches (Figure 4).
Mesh placed over the sutured fascial flaps and underneath the muscle layer (Sublay).
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fig5
A Prolene mesh was placed over this fascial layer and fixed to the overhanging muscle flaps (Figure 5).
Muscle flaps approximated over the mesh.
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fig6
The muscle flaps were approximated over the mesh (Figure 6).