Laparoscopic Management of a Rare Lesser Sac Internal Hernia Involving the Terminal Ileum and Entire Right Colon: A Diagnostic and Surgical Challenge.

Internal hernias are an uncommon cause of bowel obstruction. The diagnosis and identification of the cause of internal herniation can be challenging, but modern imaging, particularly CT scan, facilitates preoperative identification. The foramen of Winslow hernia represents a rare subtype, accounting for a small fraction of all internal hernias and often presenting with non-specific symptoms. Most reported cases in the literature were managed through open surgery, albeit a few favored laparoscopy. This report presents a challenging case involving herniation of the terminal ileum, cecum, and ascending and transverse colon through the foramen of Winslow. We share the successful laparoscopic management, highlighting the surgical challenges and techniques used in this rare presentation.