Perineal hernia is a rare condition. It arises from weakness of the endopelvic fascia. Most perineal hernias are acquired. Several surgical approaches for repair have been advocated and they include transabdominal, transperineal, or combined approaches. Transabdominal repair with mesh has the highest reported long-term success. There is a paucity of data on laparoscopic repair of this condition. This video illustrates the laparoscopic repair with mesh.

The patient is 67 year old gentleman with symptomatic incisional perineal hernia 9 months following laparoscopic abdominoperineal resection with sartorius flap coverage for T3N0 recurrent anal carcinoma. A three trocar technique is undertaken to repair the hernia with dual mesh.

Uneventful intraoperative and postoperative course was noted. Short-term follow-up revealed no recurrent disease.

Laparoscopic transabdominal repair of incisional perineal hernia is technically feasible with good results.