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腹腔镜手术后5毫米套管穿刺部位肠疝

5-millimeter trocar-site bowel herniation following laparoscopic surgery.

作者信息

Khurshid Nauman, Chung Maurice, Horrigan Terrence, Manahan Kelly, Geisler John P

机构信息

University of Toledo Medical Center, Dept OBGYN, Toledo, OH 43614, USA.

出版信息

JSLS. 2012 Apr-Jun;16(2):306-10. doi: 10.4293/108680812x13427982376987.

Abstract

BACKGROUND AND OBJECTIVES

This is a case report of a 5-mm trocar-site large bowel herniation following laparoscopic tubal sterilization. During laparoscopic sterilization, the 5-mm port site was closed initially. Large bowel herniation was recognized at the end of the case and managed immediately by laparoscopically reducing the hernia and closing the port site without any short- or long-term complications. Trocar-site bowel hernia is a rare complication after laparoscopic surgery. It is usually associated with trocar size > 10 mm. We describe a case of bowel herniation through a 5-mm trocar site, which was managed after laparoscopic surgery.

CASE REPORT

A 36-year-old multigravid patient underwent a laparoscopic tubal fulguration. Two 5-mm ports were used for the procedure. At the end of the procedure, the lateral trocar site was found to have fat protrusion that looked like appendices epiploicae. A laparoscopic camera was reintroduced into the abdominal cavity that showed a large bowel herniation through the 5-mm lateral port site. The hernia was reduced laparoscopically, and the fascial defect was repaired.

CONCLUSION

Bowel herniation can occur through a 5-mm port. All port sites should be closed to avoid such complications.

摘要

背景与目的

本文是一例腹腔镜输卵管绝育术后5毫米套管针穿刺部位大肠疝出的病例报告。在腹腔镜绝育手术过程中,最初关闭了5毫米的穿刺孔。在手术结束时发现大肠疝出,并立即通过腹腔镜将疝复位并关闭穿刺孔,未出现任何短期或长期并发症。套管针穿刺部位肠疝是腹腔镜手术后一种罕见的并发症。它通常与直径大于10毫米的套管针有关。我们描述了一例通过5毫米套管针穿刺部位发生的肠疝病例,该病例在腹腔镜手术后得到了处理。

病例报告

一名36岁的多产妇接受了腹腔镜输卵管电凝术。手术中使用了两个5毫米的穿刺孔。手术结束时,发现外侧穿刺孔部位有脂肪突出,看起来像网膜。将腹腔镜摄像头重新插入腹腔,显示大肠通过5毫米的外侧穿刺孔疝出。通过腹腔镜将疝复位,并修复了筋膜缺损。

结论

肠疝可通过5毫米的穿刺孔发生。所有穿刺孔部位均应关闭以避免此类并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e858/3481230/edc84ea1fd7d/jls0021228770001.jpg

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