Pandey Anshuman, Masood Shakeel, Goel Vijay Kumar, Gupta Amit Kumar
Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
Asian J Endosc Surg. 2014 Nov;7(4):330-3. doi: 10.1111/ases.12124.
For ventral hernia repair, laparoscopic surgery offers various advantages, including the application of a large mesh using the intraperitoneal approach. However, improper closure of the port site may lead to serious complications. Port-site hernia is a rare outcome of inadequate repair of the fascial or peritoneal layer, and Richter's hernia in a high risk patient, in the presence of an intraperitoneal mesh, is a particularly challenging scenario. Herein, we present a 58-year-old woman who, after a ventral hernia repair, was diagnosed with a small bowel hernia through a 10-mm port site. The patient complained of pain and mild swelling at the port site in the postoperative period, and her symptoms indicated intestinal obstruction. Clinical evaluation and abdominal X-ray confirmed the diagnosis, and early laparoscopic re-exploration and management were the key to a favorable outcome.
对于腹疝修补术,腹腔镜手术具有多种优势,包括采用腹腔内入路应用大型补片。然而,切口部位关闭不当可能导致严重并发症。切口疝是筋膜或腹膜层修复不充分的罕见后果,而在腹腔内置入补片的情况下,高危患者发生里脱疝是一种特别具有挑战性的情况。在此,我们报告一名58岁女性,在腹疝修补术后,通过一个10毫米的切口部位被诊断为小肠疝。患者在术后期间主诉切口部位疼痛和轻度肿胀,其症状提示肠梗阻。临床评估和腹部X线检查确诊了病情,早期腹腔镜再次探查和处理是取得良好预后的关键。