Laparoscopic Repair of Internal Hernia at the Pelvic Floor After Low Anterior Resection: A Case Report

Internal hernia following colorectal surgery is an uncommon but serious complication. Most reported cases have involved hernias resulting from mesenteric defects after left-sided colon resection. We herein report a case of laparoscopic repair of an internal hernia at the pelvic floor following low anterior resection. A 78-year-old woman with a history of robotic low anterior resection for rectal cancer presented to our hospital with severe abdominal pain and vomiting. Computed tomography revealed a strangulated bowel passing dorsally behind the reconstructed colon in the pelvis, prompting emergency surgery. The hernia orifice was formed by the levator ani and the reconstructed colon. We successfully reduced the hernia, laparoscopically sutured the orifice, and resected the strangulated bowel segment. The patient was discharged without complications and has experienced no hernia recurrence to date. Although internal hernia at the pelvic floor is very rare, this case demonstrates that safe laparoscopic reduction and repair are possible.