Shirakabe Katsudai, Hirotada Muramatsu, Kanzaki Masaki
Department of General Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.
J Surg Case Rep. 2023 Mar 9;2023(3):rjad099. doi: 10.1093/jscr/rjad099. eCollection 2023 Mar.
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.
疝修补术是普通外科医生进行的常见手术。腹腔镜疝修补术的应用近年来有所增加；它于20世纪80年代被引入，具有微创性且并发症较少。然而，由于这种增加，以前未知的罕见并发症已被报道。一名63岁男性因左侧腹股沟疝接受了经腹腹膜前补片修补术（TAPP）。腹膜关闭时感觉到腹膜有张力。术后第5天，患者因小肠梗阻（SBO）入院并接受再次手术；闭合的腹膜被撕裂，由于腹膜前间隙疝出导致SBO。疝松解后，腹膜再次关闭，手术完成。TAPP手术后的SBO是一种罕见的并发症。一些报告显示吻合器、倒刺缝线和钉合器会导致SBO；这种并发症可以通过适当的腹膜关闭技术预防，并通过早期腹腔镜手术治疗。
