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Case Reports
. 1999 Jan-Mar;3(1):79-81.

Transmesenteric hernia after laparoscopic-assisted sigmoid colectomy

Y J Kawamura  1 , E Sunami, T Masaki, T Muto
Affiliations
Case Reports

Transmesenteric hernia after laparoscopic-assisted sigmoid colectomy

Y J Kawamura et al. JSLS. 1999 Jan-Mar.

Abstract

Background and objectives: Laparoscopic-assisted surgery has been applied for a variety of colonic surgery. The objective of this paper is to demonstrate a possible and avoidable complication of laparoscopic colonic 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 postoperative 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.

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Figures

Figure 1.
Figure 1.
Barium enema finding. Barium enema study demonstrated a 1.5 cm × 1.8 cm polypoid lesion.
Figure 2.
Figure 2.
Gasless laparoscopic-assisted sigmoid colectomy.
Figure 3.
Figure 3.
Resected specimen. Pathological examination revealed a well differentiated submucosal invasive cancer.
Figure 4.
Figure 4.
Abdominal X-ray after ingestion of contrast medium. A dilated loop of the small bowel is indicated by arrows. The anastomotic site is identified by the staples, as indicated by the arrowhead.
See this image and copyright information in PMC

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