Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Feb 14:2:48.
doi: 10.1186/1752-1947-2-48.

Port site herniation of the small bowel following laparoscopy-assisted distal gastrectomy: a case report

Tsuyoshi Itoh  1 , Nobuaki Fuji, Hiroki Taniguchi, Taiji Watanabe, Toshiyuki Kosuga, Kingo Kashimoto, Kazuyo Naito
Affiliations

Port site herniation of the small bowel following laparoscopy-assisted distal gastrectomy: a case report

Tsuyoshi Itoh et al. J Med Case Rep. .

Abstract

Introduction: Port-site herniation is a rare but potentially dangerous complication after laparoscopic surgery. Closure of port sites, especially those measuring 10 mm or more, has been recommended to avoid such an event.

Case presentation: We herein report the only case of a port site hernia among a series 52 consecutive cases of laparoscopy-assisted distal gastrectomy (LADG) carried out by our unit between July 2002 and March 2007. In this case the small bowel herniated and incarcerated through the port site on day 4 after LADG despite closure of the fascia. Initial manifestations experienced by the patient, possibly due to obstruction, and including mild abdominal pain and nausea, occurred on the third day postoperatively. The definitive diagnosis was made on day 4 based on symptoms related to leakage from the duodenal stump, which was considered to have developed after severe obstruction of the bowel. Re-operation for reduction of the incarcerated bowel and tube duodenostomy with peritoneal drainage were required to manage this complication.

Conclusion: We present this case report and review of literature to discuss further regarding methods of fascial closure after laparoscopic surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Schematic view of port placement during surgery. Arabic number indicates the size of the port (mm). Herniation occurred at the port site indicated with an asterisk.
Figure 2
Figure 2
Computed tomography (CT) shows the enlarged duodenum and a mass lesion protruding into the muscular layer of the abdominal wall (arrowhead).
Figure 3
Figure 3
Intraoperative finding showing complete obstruction of the bowel due to incarceration into the peritoneal defect at the trocar site (arrow).
See this image and copyright information in PMC

References

    1. Boughey JC, Notingham JM, Walls AC. Richter's hernia in the laparoscopic era. Four case reports and review of the literature. Surg Laparosc Endosc Percutan Tech. 2003;13:55–58. doi: 10.1097/00129689-200302000-00014. - DOI - PubMed
    1. Kadar N, Reisch H, Liu CY, Manko GF, Gimpelson R. Incisional hernias after major laparoscopic gynecologic procedures. Am J Obstet Gynecol. 1993;168:1493–1495. - PubMed
    1. Liu CD, McFadden DW. Laparoscopic port sites do not require fascial closure when nonbladed trocars are used. Am Surg. 2000;66:853–854. - PubMed
    1. Kolata RJ, Ransick M, Briggs L, Baum D. Comparison of wounds created by non-bladed trocars and pyramidal tip trocars in the pig. J Laparoendosc Adv Surg Tech A. 1999;9:455–461. - PubMed
    1. Margossian H, Pollard RR, Walters MD. Small bowel obstruction in a peritoneal defect after laparoscopic Burch procedure. J Assoc Gynecol Laparosc. 1999;6:343–345. doi: 10.1016/S1074-3804(99)80074-7. - DOI - PubMed

LinkOut - more resources