Perineal hernia repair using permanent suture and mesh: a video case presentation.

Perineal hernias are an uncommon cause of pelvic bulge symptoms in women with no established ideal surgical approach. We present the case of a posterior perineal hernia repaired robotically using permanent sutures and mesh. A 67-year-old woman with a posterior perineal hernia and stage III uterovaginal prolapse presented to our office and underwent minimally invasive robotics-assisted abdominal surgery. Her levator plate defect was closed primarily using permanent sutures and reinforced using polypropylene mesh. A concomitant supracervical hysterectomy and sacrocolpopexy were performed. Robotics-assisted transabdominal perineal hernia repair offered excellent intra-operative visualization and complete delineation of the defect. Robotics-assisted abdominal primary repair of the perineal hernia and overlying mesh placement offered a safe and effective repair of this rare disorder.