Fallopian tube herniation from trocar-site after laparoscopic appendectomy

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Abdominal Wall Reconstruction

Background:

• Trocar site hernias are incisional hernias occurring post-laparoscopy.
• Incidence is approximately 1.85%, with 10mm ports being more common.
• Herniation through a 5mm port is exceptionally rare.

Observation:

• A 19-year-old female presented with discharge from a right lower quadrant trocar site two days post-laparoscopic appendectomy.
• Physical examination revealed no tenderness, but abdominal CT identified an edematous tubular structure herniating from the 5 mm port site.
• Laparoscopic re-operation confirmed herniation of the right fallopian tube through the 5 mm trocar site defect.

Findings:

• The 5 mm trocar site hernia contained the patient's right fallopian tube.
• The herniated fallopian tube was successfully reduced and appeared healthy.
• The trocar site defect was surgically closed with 2/0 polypropylene suture.

Implications:

• This case underscores that even small (5 mm) trocar sites can lead to rare but serious complications like organ herniation.
• Early recognition and surgical intervention are crucial for managing trocar site hernias.
• Clinicians should consider the possibility of any intra-abdominal organ herniating through trocar defects, not just bowel obstruction.