[Complications due to mechanical sutures in laparoscopic surgery: bowel obstruction caused by staple. Case report and literature review]

Abstract

Bowel obstruction after laparoscopic surgical operation is reported only in few cases. The incarceration of bowel loop occurs into the port site more frequently. The case of a young woman, subjected to laparoscopic appendectomy is reported: bowel obstruction occurs on the third postoperative day caused by a staple of the mechanical suture on the caecum, hooked to bowel mesentery. This complication can occur for staples partially formed, spilled in the peritoneum or put to the extremity of mechanical sutures: they can hook to fixed structures and strangle a bowel loop. It may occur in 1.8% of surgical laparoscopic procedures. It can be solved by the simple laparoscopic lysis, above all if an early diagnosis and surgical operation are performed. It is recommendable to remove all the free spilled staples in the peritoneum and close or remove those partially formed to the extremities of the suture.