Related Experiment Video
Updated: Jun 25, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Abdominal wall paresis as a complication of laparoscopic surgery
G H van Ramshorst1, G-J Kleinrensink, J J Hermans
1Department of Surgery, Erasmus University Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands. g.vanramshorst@erasmusmc.nl
Purpose:
Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy.
Methods:
A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patient presenting with paresis of the internal oblique muscle due to a trocar lesion of the right iliohypogastric nerve after laparoscopic appendectomy.
Results:
Trocar placement in the upper lateral abdomen can damage the subcostal nerve (Th12), caudal intercostal nerves (Th7-11) and ventral rami of the thoracic nerves (Th7-12). Trocar placement in the lower abdomen can damage the ilioinguinal (L1 or L2) and iliohypogastric nerves (Th12-L1). Pareses of abdominal muscles due to trocar placement are rare due to overlap in innervation and relatively small sizes of trocar incisions.
Conclusion:
Knowledge of the anatomy of the abdominal wall is mandatory in order to avoid the injury of important structures during trocar placement.
Related Concept Videos
Muscles of the Abdomen
Anterolateral Region
The anterolateral region comprises five paired muscles classified into the lateral and anterior...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Peritoneum
Anatomy of the Peritoneum
The peritoneum is divided into two layers: the parietal peritoneum and the visceral...
Appendicitis
Intestinal Obstruction II: Pathophysiology

