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Updated: Apr 30, 2026
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Two case reports of perineal hernia after laparoscopic abdominoperineal resection with a proposed modification to the
L C Ewan1, P J Charleston, S H Pettit
1Blackpool Teaching Hospitals NHS Foundation Trust, UK.
Abstract:
Perineal hernia is a rare complication following laparoscopic abdominoperineal resection (APR) for rectal cancer. We present two case reports of perineal hernia following laparoscopic APR and discuss their management. We suggest that they developed because the pelvic peritoneum was left open during laparoscopic APR and propose that closure of the pelvic peritoneum should be routine in this operation.
Insights
Perineal hernia is a rare complication after rectal cancer surgery. Leaving the pelvic peritoneum open during laparoscopic abdominoperineal resection (APR) may cause these hernias, suggesting routine closure is needed.
Area of Science:
- Surgical oncology
- Gastrointestinal surgery
- Pelvic floor disorders
Background:
- Rectal cancer treatment often involves abdominoperineal resection (APR).
- Laparoscopic APR is a minimally invasive approach.
- Perineal hernia is a known, albeit rare, complication post-APR.
Observation:
- Two cases of perineal hernia following laparoscopic APR were observed.
- The common factor identified was an open pelvic peritoneum during the procedure.
Findings:
- Perineal hernias post-laparoscopic APR are linked to an open pelvic peritoneum.
- Management strategies for these hernias were discussed.
Implications:
- Routine closure of the pelvic peritoneum during laparoscopic APR may prevent perineal hernia formation.
- This practice could improve patient outcomes after rectal cancer surgery.
