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Case Reports
. 2023 Mar 9;2023(3):rjad099.
doi: 10.1093/jscr/rjad099. eCollection 2023 Mar.

Preperitoneal herniation after transabdominal preperitoneal patch plasty: a case report

Katsudai Shirakabe  1 , Muramatsu Hirotada  1 , Masaki Kanzaki  1
Affiliations
Case Reports

Preperitoneal herniation after transabdominal preperitoneal patch plasty: a case report

Katsudai Shirakabe et al. J Surg Case Rep. .

Abstract

Hernial repair is a common procedure performed by general surgeons. The use of laparoscopic hernial repair has recently increased; it was introduced in the 1980s, is minimally invasive and has few complications. However, because of this increase, rare complications that were previously unknown have been reported. A 63-year-old man underwent transabdominal preperitoneal patch plasty (TAPP) for a left inguinal hernia. Tension was felt in the peritoneum during peritoneal closure. On the fifth postoperative day, the patient was admitted for small bowel obstruction (SBO) and underwent reoperation; the closed peritoneum was lacerated, causing SBO because of herniation of the preperitoneal space. After the hernia was released, the peritoneum was closed again, and the surgery was completed. SBO after TAPP surgery is a rare complication. Several reports have shown staplers, barbed sutures and tacks causing SBO; this complication can be prevented with appropriate peritoneal closure techniques and treated with early laparoscopic surgery.

Keywords: hernia; laparoscopy; peritoneum; small bowel obstruction.

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Figures

Figure 1
Figure 1
The white arrow shows the site of caliber change in the small bowel (axial section image).
Figure 2
Figure 2
The white arrow shows the small bowel incarcerating into the preperitoneal space (coronal section image).
Figure 3
Figure 3
The closed peritoneum was lacerated, and the small bowel was incarcerated in the preperitoneal space.
Figure 4
Figure 4
The lacerated peritoneal hole formed a hernia orifice.
See this image and copyright information in PMC

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