Preperitoneal herniation after transabdominal preperitoneal patch plasty: a case report.

Area of Science:

• General Surgery
• Minimally Invasive Surgery
• Surgical Complications

Background:

• Laparoscopic hernia repair, including transabdominal preperitoneal patch plasty (TAPP), has become increasingly common since the 1980s.
• While minimally invasive, TAPP is associated with rare complications that are becoming more recognized with increased usage.
• Proper peritoneal closure is crucial for preventing complications during laparoscopic procedures.

Observation:

• A 63-year-old male patient developed small bowel obstruction (SBO) on the fifth postoperative day after undergoing TAPP for an inguinal hernia.
• During the initial surgery, tension was noted during peritoneal closure, suggesting a potential issue with the closure.
• Reoperation revealed a lacerated peritoneum, leading to SBO due to herniation into the preperitoneal space.

Findings:

• Small bowel obstruction (SBO) is a rare but serious complication following TAPP surgery.
• Previous reports have linked SBO after TAPP to surgical materials like staplers, barbed sutures, and tacks.
• This case highlights peritoneal dehiscence as a cause of SBO after TAPP, emphasizing the importance of secure peritoneal closure.

Implications:

• Secure and appropriate peritoneal closure techniques are essential to prevent SBO after TAPP.
• Early diagnosis and laparoscopic re-intervention are effective treatment strategies for SBO following TAPP.
• Increased vigilance for rare complications is necessary as minimally invasive surgical techniques gain wider adoption.