Iatrogenic semilunar line hernias: challenging cases and varying treatment options

Achoimre

Abstract Semilunar line incisional hernias are a complex and under-recognized subset of ventral hernias that arise following surgical or traumatic disruption of the semilunar line. These hernias present unique challenges due to their anatomical location, high incidence of rectus muscle denervation, and reduced fascial integrity. Limited literature exists on their identification and management. We present a case series of three patients with semilunar line incisional hernias, each requiring surgical intervention. The surgical approach was tailored based on hernia size, muscle integrity, and patient-specific factors. Techniques included fascial closure with sublay mesh reinforcement, layered closure without mesh, and a bridging mesh repair as part of a staged approach. All three patients underwent successful hernia repairs with no immediate postoperative complications. Follow-up at three months showed no evidence of recurrence. Semilunar line incisional hernias require individualized surgical planning. Further research is needed to establish optimal repair strategies and long-term outcomes.