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Lumbar hernias are rare abdominal wall defects. Fewer than 400 cases have been reported in the literature and account for 2% of all abdominal wall hernias. Lumbar hernias are divided into Grynfelt-Lesshaft or Petit hernias. The former are hernia defects through the superior lumbar triangle, while the latter are defects of the inferior lumbar triangle. Primary lumbar hernias are further subdivided into congenital or acquired hernias and can further be classified as either primary or secondary. Secondary hernias occur after previous flank surgeries, iatrogenic muscular disruption, infection, or trauma. We review a rare presentation of metachronous symptomatic bilateral secondary acquired lumbar hernia following spine surgery. A successful laparoscopic transabdominal lumbar hernia repair with extraperitoneal mesh placement was performed, with resolution of the hernia symptoms. An extensive literature review regarding lumbar hernia and different types of repairs was performed.

To improve equitable access to geospatial analysis, a free open-source R package, called Rosymap, was created to map trauma incident locations. To demonstrate the R package, penetrating trauma events for all patients who received care at a level one trauma center, and the locations of all “Stop the Bleed” training locations between 2019 and 2022 were geospatially analyzed. The level one trauma center treated 1531 patients for penetrating traumas between 2019 and 2022. Using Rosymap, a map was produced showing the poor overlap in distribution between penetrating traumas and “Stop the Bleed” training locations. Rosymap, a free open-source GIS R package, visualized that the majority of “Stop the Bleed” training locations were not performed within clusters of penetrating traumas serviced by our level one trauma center. These results suggest that trauma providers and public health advocates should consider geospatial analysis when planning interventions and when attempting to choose locations equitably and accurately. To facilitate and promote the implementation of geospatial analysis, Rosymap is available as open-source code. •Geospatial analysis can improve public health intervention location selection.•Our open-source code provides a free geospatial analysis tool to the public.•Open-source software allows for community improvement and expansion.