Hernia at 5-mm laparoscopic port site presenting as early postoperative small bowel obstruction. 1999

P R Reardon, and A Preciado, and T Scarborough, and B Matthews, and J L Marti
Department of Surgery, Baylor College of Medicine and The Methodist Hospital, Houston, Texas, USA. reardonp@bcm.tme.edu

A decade has passed since laparoscopy became a popular tool in general surgery. New technologies continue to surface, and surgeons are still trying to expand the applications of this technique. Parallel to the development of new techniques, we are also measuring the presentation of new complications. Incisional hernias are not new complications. Although their avoidance has been one of the proposed benefits of laparoscopy, several cases of port-site hernias have been reported. Current surgical wisdom suggests closure of 10-mm or larger port sites to avoid herniation. Most surgeons do not routinely close 5-mm port sites, believing that such fascial defects are not large enough to create a significant risk of hernia formation, thus not justifying the extra time and effort needed to close them. Although this practice may be reasonable for most cases, it should be reconsidered in lengthy procedures, particularly if the port has been used for active operative instruments. Under these circumstances, the repetitive motions in different directions may cause the 5-mm defect to enlarge significantly, allowing a hernia of considerable size to develop, with the obvious clinical implications of such a complication. We present a case of a hernia through a 5-mm port site presenting as small-bowel obstruction in the early postoperative period after a laparoscopic paraesophageal hernia repair.

UI MeSH Term Description Entries
D007415 Intestinal Obstruction Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL. Intestinal Obstructions,Obstruction, Intestinal
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D006551 Hernia, Hiatal STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, the esophageal hiatus. Hernia, Esophageal,Hernia, Paraesophageal,Hiatal Hernia,Esophageal Hernia,Hernia, Hiatus,Paraesophageal Hiatal Hernia,Sliding Esophageal Hernia,Sliding Hiatal Hernia,Esophageal Hernia, Sliding,Esophageal Hernias,Esophageal Hernias, Sliding,Hernia, Paraesophageal Hiatal,Hernia, Sliding Esophageal,Hernia, Sliding Hiatal,Hernias, Esophageal,Hernias, Hiatal,Hernias, Hiatus,Hernias, Paraesophageal,Hernias, Paraesophageal Hiatal,Hernias, Sliding Esophageal,Hernias, Sliding Hiatal,Hiatal Hernia, Paraesophageal,Hiatal Hernia, Sliding,Hiatal Hernias,Hiatal Hernias, Paraesophageal,Hiatal Hernias, Sliding,Hiatus Hernia,Hiatus Hernias,Paraesophageal Hernia,Paraesophageal Hernias,Paraesophageal Hiatal Hernias,Sliding Esophageal Hernias,Sliding Hiatal Hernias
D006555 Hernia, Ventral A hernia caused by weakness of the anterior ABDOMINAL WALL due to midline defects, previous incisions, or increased intra-abdominal pressure. Ventral hernias include UMBILICAL HERNIA, incisional, epigastric, and spigelian hernias. Ventral Hernia,Hernias, Ventral,Ventral Hernias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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