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Small bowel obstruction secondary to herniation through a 5-mm laparoscopic trocar site following laparoscopic
1Division of Gynecologic Oncology, University of Vermont, Burlington 05401, USA.
Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. This is a report of a 54-year-old woman with endometrial cancer who presented with nausea, vomiting and abdominal pain 1 week following laparoscopically-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Abdominal radiographs and computed tomography demonstrated small bowel obstruction and herniation through a 5-mm trocar site. Reduction of the hernia and closure of the fascial incision were performed at exploratory laparotomy with normal recovery. Bowel herniation can occur through 5-mm trocar sites following prolonged operative laparoscopy. The peritoneum and fascia of these incisions should be closed.
Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. This is a report of a 54-year-old woman with endometrial cancer who presented with nausea, vomiting and abdominal pain 1 week following laparoscopically-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Abdominal radiographs and computed tomography demonstrated small bowel obstruction and herniation through a 5-mm trocar site. Reduction of the hernia and closure of the fascial incision were performed at exploratory laparotomy with normal recovery. Bowel herniation can occur through 5-mm trocar sites following prolonged operative laparoscopy. The peritoneum and fascia of these incisions should be closed.