Subcutaneous emphysema and hypercarbia as a complication of laparoscopic procedure: case report

Aldakhil, Sadal K; Tashkandi, Abeer; Harbi, Mohammed K Al; Shehri, Adel Al

doi:10.1093/jscr/rjz415

Cited by 5 publications

(1 citation statement)

References 7 publications

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“…Subcutaneous emphysema is a potential complication of laparoscopic surgery but is more likely to occur in extraperitoneal surgery as insufflated CO 2 can easily diffuse into surrounding tissues. High insufflation pressure increases the risk and is the most likely cause of this complication (19,20). The rapid diffusion of CO 2 and occurrence of subcutaneous emphysema can be attributed to the fact that the extraperitoneal space is continuous with the subcutaneous space.…”

Section: Discussionmentioning

confidence: 99%

Modified Laparoscopic Sugarbaker Repair of Parastomal Hernia With a Totally Extraperitoneal Technique

Jiang¹,

Thapa

Cai³

et al. 2021

Front. Surg.

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Purpose: Many patients develop a parastomal hernia within the first 2 years of stoma formation, and even surgical repair is associated with high recurrence rates. An intraperitoneal approach is typically used for the laparoscopic repair of parastomal hernia; it is unknown whether a totally extraperitoneal technique (TEP) is feasible. Here we describe a laparoscopic TEP approach using a modified Sugarbaker method for the repair of parastomal hernia.Methods: Seven patients underwent parastomal hernia repair. The retrograde puncture technique was used to create the extrapneumoperitoneum, and the peritoneum was separated with a laparoscopic TEP approach; the mesh was placed using a modified Sugarbaker technique.Results: All patients had an oncologic etiology for stoma creation. The mean (±SD) size of the hernia defect was 3.1 ± 2.7 cm and the mesh size was 303.4 ± 96.8 cm2. The mean operative time was 195.5 ± 20.7 min and average length of hospital stay after surgery was 4.8 ± 2.1 days. One patient had intraoperative subcutaneous emphysema. The average follow-up time was 8.5 ± 2.7 months; mild pain occurred in 2 patients, 3 experienced seroma formation (with no special treatment required), and 1 had early intestinal obstruction (which was treated with conservative care). There was no hernia recurrence, wound complications, or infections of the surgical site or mesh during follow-up.Conclusion: A laparoscopic TEP technique is technically challenging but feasible. Modified laparoscopic Sugarbaker repair of a parastomal hernia with the TEP technique is safe and effective, although the recurrence rate and late complications require confirmation in more cases with long-term follow-up.

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Section: Discussionmentioning

confidence: 99%