Small Bowel Obstruction Secondary to Incarcerated Richter's Hernia from Laparoscopic Hernia Repair

Wegener, Michael E.; Chung, Daniel T M; Crans, Charles A.; Chung, D

doi:10.1089/lps.1993.3.173

Cited by 28 publications

(9 citation statements)

References 5 publications

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“…Although there have been a number of case reports de scribing herniation at laparoscopic trocar sites [6,7,9,12,14,19,20,22,24,27,28,30], there have been surprisingly few studies [1,15,17,18,23] examining the exact frequency of this complication after laparoscopic surgery and none that have specifically addressed its frequency after laparoscopic fundoplication. Therefore, we set out to ascertain the frequency of trocar site herniation in a cohort of patients who had undergone laparoscopic fundoplication and second to examine the characteristics of affected individuals so that any putative risk factors for the development of trocar site herniation could be identified.…”

mentioning

confidence: 99%

Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication

et al. 2001

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The prevalence of trocar site herniation after laparoscopic fundoplication was minimal at 3%. All hernias occurred at the midline supraumbilical port, the only site where open trocar insertion was employed. As a consequence of these observations, we have developed a new method of open trocar placement. This method utilizes a paramedian skin incision and separate fascial incisions through anterior and posterior rectus sheathes, with retraction of the rectus abdominis muscle laterally.

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mentioning

confidence: 99%

Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication

et al. 2001

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“…This is of significance because hernias causing symptoms do not necessarily penetrate the fascia. Several trocar hernias located inside as well as outside the sheath of the rectus muscle have been found to be preperitoneal, but subfascial 15,16 …”

Section: Discussionmentioning

confidence: 99%

Richter's hernia as an unusual complication of laparoscopic sterilization: a case report and review

et al. 2002

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Umbilical port site hernia, with minor procedures like laparoscopic sterilization, especially with port of 10 mm or less are very rare. Those involving bowel mainly occur as Richter's hernia, which may be very difficult to diagnose as only a part of bowel wall is involved and the rest of the bowel might be functioning. Therefore the bowel sounds may persist. It is a serious complication as it may cause bowel obstruction, incarceration, necrosis and perforation resulting in peritonitis. Open surgery with reduction of the hernia is the usual mode of treatment, if the bowel is viable, whereas resection is needed if the bowel wall is not viable. High index of suspicion in these cases can lead to early diagnosis, and thus delaying the above life threatening complications.

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“…Strangulation and necrosis of the knuckled bowel may occur [15]. To completely prevent a Richter's-type hernia, the preperitoneal space must also be closed [19]. The reported incisional hernias, after operative gynecological laparoscopy, have appeared within the first 10 days of surgery in all but one patient, who had an incarcerated hernia repaired a year after surgery [9].…”

Section: Discussionmentioning

confidence: 99%

New closure technique for lateral operative laparoscopic trocar sites

et al. 1995

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The reported frequency of incisional hernias, after operative gynecological laparoscopy, at extraumbilical trocar sites is one per 32 puncture sites created by a 12-mm trocar. A new closure technique of suturing with the Grice Needle (Ideas for Medicine, Inc., Clearwater, FL) before removing the trocars was utilized to close 80 lateral trocar sites (42 consecutive laparoscopic myomectomies). The trocar sizes in this study were 12 mm and 18 mm. This is the largest reported series of lateral trocar-site closures. No hematomas or bleeding or incisional hernias have resulted from use of this technique. This closure allows the surgeon to completely close both peritoneum and fascia, of the lateral trocar sites, under direct laparoscopic visualization without the loss of pneumoperitoneum or risk of inadvertent injury to the small bowel.

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Small Bowel Obstruction Secondary to Incarcerated Richter's Hernia from Laparoscopic Hernia Repair

Cited by 28 publications

References 5 publications

Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication

Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication

Richter's hernia as an unusual complication of laparoscopic sterilization: a case report and review

New closure technique for lateral operative laparoscopic trocar sites

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