Left laparoscopic paraduodenal hernia repair

Abstract

The current data lead to the conclusion that laparoscopic paraduodenal hernia repair is a safe and feasible approach for selected patients. It can be expected that as surgeons become increasingly comfortable and facile with laparoscopic techniques, paraduodenal hernias and many other causes of acute small bowel obstruction will be increasingly managed laparoscopically.

Left Paraduodenal Hernia: Case Report and Literature Review

“…2,8 Peritoneal fossae develop between the 5th and 11 th gestational week due to an incomplete fusion of the posterior parietal peritoneum and the posterior abdominal wall. Superior and inferior duodenal fossae are most commonly found, in about 1-2% of cases a left paraduodenal fossa lateral to the fourth portion of the duodenum and posterior to the inferior mesenteric vein (IMV) and left colic artery is present (fossa of Landzert) 9,10 . The pathophysiology of hernia formation is not entirely clear.…”

“…Since in PDH a very proximal obstruction without extensive bowel distension is present, there is usually sufficient working space for laparoscopy. To date 15 cases of laparoscopic PDH repair have been reported in 11 publications 9 . Of these 73% were left sided and in 77% of cases the hernia was primarily closed.…”

“…There is no consensus about how to close the hernial defect; both continuous and interrupted suturing techniques seem acceptable. All the patients had resumed oral diet by post-operative day three and the mean duration of hospitalization was four days 9 . Most authors consider apparent bowel ischemia or gangrene a contraindication tolaparoscopy or an indication to convert to an open procedure 3,4,9 .…”

“…All the patients had resumed oral diet by post-operative day three and the mean duration of hospitalization was four days 9 . Most authors consider apparent bowel ischemia or gangrene a contraindication tolaparoscopy or an indication to convert to an open procedure 3,4,9 . In conclusion, PDH is a difficult in diagnosis and that requires a high index of suspicion from the surgeon and appropriate imaging.…”

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

“…Even though all of the studies are of low LE, the potential role of laparoscopy in the diagnosis seems to be demonstrated in them and would, at times, prevent unnecessary laparotomies [298][299][300][301][302][303][304][305][306][307][308][309][310][311][312][313][314][315][316][317].…”