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经腹腹膜前(TAPP)疝修补术后发生内疝:一例病例报告。

Internal hernia after trans-abdominal preperitoneal (TAPP) hernia repair: A case report.

作者信息

Caruso Giovambattista, Cantella Roberto, Di Guardo Eleonora, Torrisi Alberto, Reina Martina, Reina Giuseppe Angelo

机构信息

General Surgery Department, Santissimo Salvatore Hospital (ASP Catania), Paternò, Catania, Italy.

General Surgery Department, Santissimo Salvatore Hospital (ASP Catania), Paternò, Catania, Italy.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110445. doi: 10.1016/j.ijscr.2024.110445. Epub 2024 Oct 16.

Abstract

INTRODUCTION

Hernia repair is a common procedure performed by general surgeons. Introduced in 1990s, the use of laparoscopic hernia repair has recently increased and, consequently, rare complications previously unknown have been reported.

PRESENTATION OF CASE

A 43-years-old male patient who underwent a transabdominal preperitoneal patch plasty (TAPP) procedure for symptomatic bilateral inguinal hernia. On the sixth postoperative day, the patient was admitted for small bowel obstruction (SBO) and underwent reoperation; the central portion of the peritoneal suture in the left inguinal region was lacerated and a hole in the peritoneum had performed a hernia orifice, causing small bowel occlusion by preperitoneal herniation. After the hernia was released, the peritoneum was closed again and the surgery was completed.

DISCUSSION

SBO after TAPP procedure is a rare complication and should be considered in patients with abdominal pain and vomiting after TAPP procedure.

CONCLUSION

This complication can be prevented with appropriate peritoneal closure techniques and treated with early laparoscopic surgery.

摘要

引言

疝修补术是普通外科医生实施的常见手术。腹腔镜疝修补术于20世纪90年代引入,近年来其应用有所增加,因此,此前未知的罕见并发症也有报道。

病例介绍

一名43岁男性患者因双侧腹股沟疝有症状接受了经腹腹膜前补片修补术(TAPP)。术后第六天,患者因小肠梗阻(SBO)入院并接受再次手术;左腹股沟区腹膜缝合的中央部分撕裂,腹膜上的一个洞形成了疝孔,导致腹膜前疝出引起小肠梗阻。疝松解后,腹膜再次缝合,手术完成。

讨论

TAPP术后的SBO是一种罕见的并发症,对于TAPP术后出现腹痛和呕吐的患者应予以考虑。

结论

这种并发症可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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b20b/11532445/f65dd6a12bb7/gr1.jpg

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