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[Abdominal pain and transit disorders following a laparoscopic procedure: be alert to a trocar hernia]

K ten Duis1, G J de Borst, P C Scholten

  • 1Afd. Heelkunde, Diakonessenhuis, Utrecht. kajtenduis@hotmail.com

Nederlands Tijdschrift Voor Geneeskunde
|August 22, 2008
PubMed

Three patients, three women aged 40, 64 and 75, suffered from a trocar hernia, a specific complication of laparoscopic surgery. This type of hernia may result in small bowel obstruction and normally appears within two weeks after laparoscopy. The usual presentation is that of abdominal pain with nausea and vomiting. Trocar herniation implicates the necessity of reposition and might result in bowel resection with prolonged hospital stay. The advice for prevention is to use a trocar with a diameter as small as possible, as the chance of a hernia occurring increases withthe use of larger trocars. Fascial closure is advised for trocars to mm and larger. With a growing number of procedures being performed laparoscopically, the importance of recognizing and preventing this complication is evident. Three cases illustrate the importance of early recognition of small bowel obstruction resulting from trocar herniation.

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