ObjectiveTo summarize the surgical experience of perineal hernia (PH) repairment after a laparoscopic abdominoperineal resection (APR) with synthetic mesh.MethodsThe clinical data of 4 cases of PH after APR from 2009 to 2015 underwent surgery were analyzed retrospectively. We applied synthetic mesh for the reconstruction of the pelvic floor.ResultsAll of the 4 cases recovered smoothly, with no complication happened. The blood loss during the operation was 50–100 mL, the operative time was 1.0–1.5 hours, the postoperative time of getting out of bed was delayed to 5–7 days after the operation and discharged after 10–14 days. Patients were advised to use transperineal bandages or rigid underpants to lift up the perineum to reduce tension after discharge. No recurrence of perineal hernia or the tumor was found on physical examination and abdominal pelvic CT scan during the 24-month follow-up.ConclusionsIt brings better effect and less trauma after the operation by using transperineal repair of PH with synthetic mesh. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.