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Trocar site herniation of the small bowel after laparoscopic bilateral adnexectomy despite fascial closure: a case report.
Acta Chir Belg. 2011 Nov-Dec; 111(6):407-9.AC

Abstract

In this paper we report a case of an incarcerated hernia occurring through the peritoneal and muscular defect caused by a previous trocar insertion. The patient developed the hernia eight days after bilateral laparoscopic adnexectomy and presented small bowel obstruction signs. This hernia occurred despite correct closure of the internal oblique fascia. The patient was re-operated and exploratory laparoscopy confirmed the diagnosis. The hernia was reduced via a small extension of the previous incision, and the defect was repaired by separated stitches. This case shows that a trocar site hernia can appear despite correct closure of the fascia, which is poorly described except for obese patients. It suggests the need for careful closure of the abdominal wall including the peritoneum after a laparoscopic procedure. Trocar site hernia has to be considered in cases of post laparoscopic small bowel obstruction. We reviewed the literature and found no randomized control study concerning this problem: only reviews, retrospective studies, case reports and technical notes. These papers are discussed and compared with our case.

Authors+Show Affiliations

Department of General Surgery, Hospital of Braine l'Alleud-Waterloo, Belgium. bnebbot@ulb.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22299332

Citation

Nebbot, B, et al. "Trocar Site Herniation of the Small Bowel After Laparoscopic Bilateral Adnexectomy Despite Fascial Closure: a Case Report." Acta Chirurgica Belgica, vol. 111, no. 6, 2011, pp. 407-9.
Nebbot B, Herve J, Thüngen T, et al. Trocar site herniation of the small bowel after laparoscopic bilateral adnexectomy despite fascial closure: a case report. Acta Chir Belg. 2011;111(6):407-9.
Nebbot, B., Herve, J., Thüngen, T., & Barthel, J. (2011). Trocar site herniation of the small bowel after laparoscopic bilateral adnexectomy despite fascial closure: a case report. Acta Chirurgica Belgica, 111(6), 407-9.
Nebbot B, et al. Trocar Site Herniation of the Small Bowel After Laparoscopic Bilateral Adnexectomy Despite Fascial Closure: a Case Report. Acta Chir Belg. 2011 Nov-Dec;111(6):407-9. PubMed PMID: 22299332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trocar site herniation of the small bowel after laparoscopic bilateral adnexectomy despite fascial closure: a case report. AU - Nebbot,B, AU - Herve,J, AU - Thüngen,T, AU - Barthel,J, PY - 2012/2/4/entrez PY - 2012/2/4/pubmed PY - 2012/3/3/medline SP - 407 EP - 9 JF - Acta chirurgica Belgica JO - Acta Chir. Belg. VL - 111 IS - 6 N2 - In this paper we report a case of an incarcerated hernia occurring through the peritoneal and muscular defect caused by a previous trocar insertion. The patient developed the hernia eight days after bilateral laparoscopic adnexectomy and presented small bowel obstruction signs. This hernia occurred despite correct closure of the internal oblique fascia. The patient was re-operated and exploratory laparoscopy confirmed the diagnosis. The hernia was reduced via a small extension of the previous incision, and the defect was repaired by separated stitches. This case shows that a trocar site hernia can appear despite correct closure of the fascia, which is poorly described except for obese patients. It suggests the need for careful closure of the abdominal wall including the peritoneum after a laparoscopic procedure. Trocar site hernia has to be considered in cases of post laparoscopic small bowel obstruction. We reviewed the literature and found no randomized control study concerning this problem: only reviews, retrospective studies, case reports and technical notes. These papers are discussed and compared with our case. SN - 0001-5458 UR - https://www.unboundmedicine.com/medline/citation/22299332/Trocar_site_herniation_of_the_small_bowel_after_laparoscopic_bilateral_adnexectomy_despite_fascial_closure:_a_case_report_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=22299332.ui DB - PRIME DP - Unbound Medicine ER -