Adhesional small bowel obstruction related to stapling device from previous laparoscopic inguinal hernia repair

Abstract

Small bowel obstruction (SBO) is common surgical presenting problem, accounting for roughly 15 000 laparotomies per year in the UK. However, SBO post laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is uncommon with an estimated incidence of 0.2%–0.5%. The common causes for SBO post-TAPP include inadequate closure, port-site herniation and adhesions. Here, we present a case of adhesional SBO related to stapling device from previous laparoscopic inguinal hernia repair and review alternative methods for mesh fixation. This case reports a rare but life-threatening complication from a commonly performed day case procedure and highlights importance of adequate surgical technique when inserting foreign bodies intra-abdominally. The patient required an emergency laparotomy and small bowel resection, developed postoperative ileus which managed with a nasogastric tube, intravenous fluids and parenteral nutrition and was discharged 12 days postoperatively.

Preperitoneal herniation as a complication of tansabdominal preperitoneal patch plasty: a report of two cases

“…Nevertheless, some serious and potentially life-threatening complications may develop. SBO after TAPP is uncommon, with an estimated incidence of 0.2–0.5% [ 10 ]. It usually results from inadequate peritoneal closure, trocar site herniation, or adhesion [ 10 – 12 , 15 ].…”

“…SBO after TAPP is uncommon, with an estimated incidence of 0.2–0.5% [ 10 ]. It usually results from inadequate peritoneal closure, trocar site herniation, or adhesion [ 10 – 12 , 15 ]. PH caused by a disrupted peritoneum is extremely rare, but it will have serious consequences if not managed in a timely manner.…”

“…Postoperative complications after LIHR include chronic pain; seroma formation; neurovascular injury; visceral injury; mesh infection, migration, and erosion; hernia recurrence; and testicular complications. Small bowel obstruction (SBO) is an uncommon complication of transabdominal preperitoneal patch plasty (TAPP), occurring with an estimated incidence of 0.2–0.5% [ 10 ]. The most common causes of SBO after TAPP include preperitoneal herniation (PH) through inadequate closure of the peritoneum and port sites as well as adhesion formation [ 10 ].…”

“…Small bowel obstruction (SBO) is an uncommon complication of transabdominal preperitoneal patch plasty (TAPP), occurring with an estimated incidence of 0.2–0.5% [ 10 ]. The most common causes of SBO after TAPP include preperitoneal herniation (PH) through inadequate closure of the peritoneum and port sites as well as adhesion formation [ 10 ]. Every hernia surgeon must be aware of these potential causes of SBO, and technical failure should be avoided.…”

Internal hernia and caecal volvulus secondary to adhesion at inguinal preperitoneal mesh

“…5 There has also been one case report in the literature which describes an adhesional small bowel obstruction that was attributed to a tack that had been placed during a laparoscopic inguinal hernia repair. 6 In vitro animal studies in pigs and rats have demonstrated intra-abdominal adhesion formation following preperitoneal mesh placement of less than 1% at three months, significantly less than in IPOM techniques. [7][8][9] In our case report, there was a band adhesion at the preperitoneal mesh that had led to an internal hernia and caecal volvulus, however, whether the mesh had initiated the adhesion is uncertain.…”