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Published on: September 27, 2024
Port site tuberculosis following laparoscopic cholecystectomy
Chintamani1, Vikas Kumar, Vinay Singhal
1Department of Surgery, Vardhman Mahavir Medical College, Safdarjang Hospital, New Delhi - 11023, India. chintamani7@rediffmail.com
Abstract:
Port site metastasis is being increasingly reported as a complication following laparoscopic surgery for malignant disorders. Various factors have been reported to be responsible and most are associated with either a high intra-peritoneal pressure due to pneumoperitoneum or the 'chimney effect' following sudden decompression of the abdomen. Direct implantation of the offending cells at the raw surface at the port has also been implicated and the use of retrieval bags is therefore recommended. We report on a rare case of port site seeding of tuberculosis in a 65-year-old woman following laparoscopic cholecystectomy.
Insights
Port site metastasis after laparoscopic surgery is a known risk. This case highlights a rare instance of tuberculosis seeding at a port site following laparoscopic cholecystectomy, emphasizing the need for vigilance.
Area of Science:
- Surgical Oncology
- Infectious Diseases
- Minimally Invasive Surgery
Background:
- Port site metastasis is an emerging complication in laparoscopic surgery for malignancies.
- Factors contributing include pneumoperitoneum pressure and the 'chimney effect'.
- Direct tumor cell implantation at port sites is also implicated, with retrieval bags recommended.
Observation:
- A rare case of tuberculosis seeding at a port site is presented.
- The patient was a 65-year-old woman.
- The complication occurred after laparoscopic cholecystectomy.
Findings:
- Tuberculosis seeding at a port site is an unusual complication of laparoscopic surgery.
- This contrasts with the more commonly reported malignant port site metastasis.
- The case underscores the potential for diverse pathogens to disseminate via surgical ports.
Implications:
- Consideration of infectious etiologies for port site complications is crucial.
- Standard protocols for preventing malignant port site metastasis may not fully address infectious seeding.
- Further research into preventing non-malignant port site seeding is warranted.