EP205 - Evolution of Operative Techniques in Perineal Hernia Repair: A 15-Year Multi-Center Review

Sunday, May 10, 2026

8:32 AM - 8:37 AM ET

ePoster Presenter(s)

Nathan Aminpour, MD

General Surgery Resident
Kaiser Permanente - Los Angeles Medical Center
Kaiser Permanente - Los Angeles Medical Center
West Hollywood, CA, United States

Disclosure information not submitted.

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Author(s)

AV

Akasha Vega, n/a

Author
Kaiser Permanente Bernard J. Tyson School of Medicine
Los Angeles, California, United States

Disclosure information not submitted.
SD

Sophia Durney, n/a

Medical Student
Kaiser Permanente Bernard J Tyson School of Medicine
Pasadena, California, United States

Disclosure information not submitted.
SS

Shamtej SinghRana, n/a

Medical Student
Kaiser Permanente Bernard J Tyson School of Medicine
pasadena, California, United States

Disclosure information not submitted.
TM

Trevor M. Marshall, B.S Molecular and Cellular Biology, UCSD

Medical Student (3rd Year)
Kaiser Permanente SOM
Pasadena, California, United States

Disclosure information not submitted.
MT

Michael S. Tam, MD

Colorectal Surgeon
Kaiser Permanente Riverside
Kaiser Permanente Riverside
Riverside, CA, United States

Disclosure information not submitted.
AF

Adil Farooqui, ABS certified

Colon and Rectal Surgeon
Kaiser Permanente West Los Angeles Medical Center
Los Angeles, California, United States

Disclosure information not submitted.

Senior Author(s)

VA

Vikram Attaluri, MD

Attending Surgeon
Kaiser Permanente
Los Angeles, California, United States

Disclosure information not submitted.

Purpose/Background: Perineal hernias remain a challenging complication following abdominoperineal resection (APR), with no consensus on the optimal repair technique. Studies have reported wide variability in recurrence rates and outcomes depending on surgical approach, mesh type, and the use of adjuncts like tissue flaps. Overall, the literature underscores the absence of a clear consensus on best practices. This study evaluates the evolution and variation of operative approaches to perineal hernia repair across multiple centers over a 15-year period.

Methods/Interventions: A retrospective review was conducted of all patients who underwent perineal hernia repair at a large integrated health system between 2010 and 2025. Patient demographic data, medical history, operative notes, and surgical findings were collected via chart review. Trends over time and differences between surgical centers and attending surgeons were analyzed. Fifteen patients underwent perineal hernia repair from 2010 – 2025. All 15 patients had a history of APR for rectal cancer with a mean time to perineal hernia repair of three years.

Results/Outcomes: Incidence of perineal hernia repair after APR was 5.5% (15/272). Five (5/15, 33%) of the patients were female and ten (10/15, 67%) were male. Mean age of the cohort was 55 (22 – 72). The two surgical techniques used were open perineal repair (60%, 9/15) and laparoscopic transabdominal repair (40%, 6/15). Mesh was used in all 15 cases, however the type of mesh differed considerably. Twelve of the cases used synthetic mesh, while three used biologic mesh. Recurrence rate after perineal hernia repair was 20% (3/15). One recurrence followed a laparoscopic transabdominal repair with synthetic mesh, while two occurred after open perineal repairs using synthetic and biologic mesh, respectively. There was a trend toward performing the surgery open via a perineal approach over time.

Conclusion/Discussion: As the incidence of rectal cancer rises with modern surgical techniques favoring extensive pelvic dissection for APR, larger perineal defects and later hernias may occur. Perineal hernia repair remains heterogenous in approach. Further work needs to be done to identify best practices for perineal hernia repair.