Objective. To demonstrate laparoscopic perineal hernia repair using VRAM flap after previous extralevator abdominoperineal excision.

Material and methods. A 60-year-old patient developed large perineal hernia in 6 months after extralevator laparoscopic abdominoperineal resection for lower rectum cancer T2N0M0. In 10 months after primary surgery, the patient underwent laparoscopic perineal hernia repair using VRAM flap.

Results. Surgery time was 210 min, intraoperative blood loss — 50 ml. The patient was activated on the day of surgery. Postoperative period proceeded without complications. The patient was discharged in 7 days after surgery. There was no recurrence of hernia throughout 12 months.

Conclusion. Postoperative perineal hernias can be effectively repaired laparoscopically using VRAM flap.

Keywords. rectal cancer, extralevator abdominoperineal resection, perineal hernia, VRAM flap