Case ReportPort Site Hernia : A Rare Complication of Laparoscopy
Introduction
Laparoscopic operations offer an advantage of rapid postoperative recovery. However a rapid expansion in the volume and complexity of laparoscopic surgery has been accompanied by complications, many of which can be directly attributed to abdominal access with laparoscopic trocars. Intestinal obstruction due to port site hernia is an uncommon cause of morbidity [1].
Sporadic reports of obstructed trocar site hernia have been reported. The treatment for such a complication requires laparotomy in most cases. We report a case of port site hernia presenting as intestinal obstruction that was successfully treated laparoscopically.
Section snippets
Case Report
A 26 year old lady underwent laparoscopic excision of right adnexal mass. Four ports were used for carrying out the procedure, of which two were 10 mm and two were 5 mm. Of the two 10mm ports one was an umbilical camera port and other was a right iliac fossa working port, which was also used to extract the specimen. The left flank had two working ports, both 5mm. The fascial defects of 10 mm ports were closed with absorbable polyglycolic acid 2/0 suture. On the third post operative day, the
Discussion
Crist and Gadacz defined trocar or port site hernia as the development of a hernia at the canula insertion site. The incidence of trocar site hernia is estimated to be between 0.65 - 2.80%. Tonouchi et al [2], suggested a classification in which these hernias were classified into three types. The early onset type had dehiscence of fascial plane and peritoneum within two weeks, most commonly with small bowel obstruction. The late onset type occurred after two weeks and had dehiscence of fascial
Conflicts of Interest
None identified
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2023, International Journal of Surgery Case ReportsLaparoscopic port site Richter's hernia - An important lesson learnt
2011, International Journal of Surgery Case ReportsCitation Excerpt :Some authors have also reported a lower incidence of hernias with the use of a paramedian incision and non bladed trocars, but these are not foolproof as has been shown by a recent case report.17–20 The management of most of these hernias includes access to the hernia by extending the trocar site, laparoscopy or an explorative laparotomy and then reduction of the hernia and further surgeries based on the bowel viability.1,4–9 In conclusion, it is necessary to repair the fascial and peritoneal layers to prevent port site hernia.
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