Transmesenteric Hernia after Laparoscopic-Assisted Sigmoid Colectomy

Background and Objectives: Laparoscopic-assisted surgery has been applied for a variety of colonie surgery. The objective of this paper is to demonstrate a possible and avoidable complication of laparoscopic colonie surgery. Case Presentation: A 47-year-old woman underwent gasless laparoscopic-assisted sigmoid colectomy. On the 20th postoperative day, she developed bowel obstruction. Decompression with a long tube failed to resolve the bowel obstruction. Open laparotomy was performed. Abdominal exploration revealed a loop of the small bowel incarcerated in the mesenteric defect caused by the previous operation. Adhesiolysis was performed, and the post-operative course was uneventful. Discussion: Despite technical difficulty, complete closure of the mesentery after bowel resection is strongly recommended for prevention of transmesenteric incarcerated hernia after laparoscopic surgery.

[1]  H. Lajer,et al.  Hernias in trocar ports following abdominal laparoscopy , 1997, Acta obstetricia et gynecologica Scandinavica.

[2]  A. Lacy,et al.  Postoperative complications of laparoscopic-assisted colectomy , 1997, Surgical Endoscopy.

[3]  C. Kum,et al.  Laparoscopic-assisted large bowel resection. , 1996, Annals of the Academy of Medicine, Singapore.

[4]  J. Sackier,et al.  Laparoscopic colectomy , 1996 .

[5]  J. H. Waldhaussen.  Incisional hernia in a 5-mm trocar site following pediatric laparoscopy. , 1996, Journal of laparoendoscopic surgery.

[6]  D. Azurin,et al.  Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. , 1995, The American surgeon.

[7]  H. Nagai,et al.  Laparoscopic-assisted colectomy and lymphadenectomy without peritoneal insufflation for sigmoid colon cancer patients , 1995, Diseases of the colon and rectum.

[8]  C. de Gheldere,et al.  Small bowel obstruction after laparoscopic inguinal hernia repair: a case report. , 1995, Acta chirurgica Belgica.

[9]  D. Kopelman,et al.  Small bowel obstruction following laparoscopic cholecystectomy: diagnosis of incisional hernia by computed tomography. , 1994, Surgical laparoscopy & endoscopy.

[10]  R. Karlin,et al.  Small bowel obstruction: a morbid complication after laparoscopic herniorrhaphy. , 1994, The American surgeon.

[11]  S. Jacobs,et al.  Small bowel obstruction following laparoscopic lymphadenectomy. , 1993, The Journal of urology.

[12]  B. Hass,et al.  Small bowel obstruction due to Richter's hernia after laparoscopic procedures. , 1993, Journal of laparoendoscopic surgery.

[13]  J. Daniell,et al.  Incarcerated incisional hernia after laparoscopy. A case report. , 1993, The Journal of reproductive medicine.