Umbilical Richter's hernia after minimally invasive laparoscopy. A case report

A case of Richter's hernia in the umbilical trocar site following laparoscopic radiofrequency thermal ablation of uterine myomas is presented. A 10-mm trocar was inserted through the umbilical site and the radiofrequency needle was introduced percutaneously into the uterine fibroid. Trocar was extracted under direct visual control after carbonic gas deflation. The fascial layer of umbilical port was not sutured. The umbilical Richter's hernia presented 13 days later required bowel resection. This case stresses the importance of suturing the fascial defects of 5-mm larger ports also in diagnostic and in minimally invasive laparoscopic procedures.