TY - JOUR
T1 - Hernia at 5-mm laparoscopic port site presenting as early postoperative small bowel obstruction
AU - Reardon, Patrick R.
AU - Preciado, Alfonso
AU - Scarborough, Terry
AU - Matthews, Brent
AU - Marti, Juan L.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1999/12
Y1 - 1999/12
N2 - A decade has passed since laparoscopy became a popular tool in general surgery. New technologies continue to surface, and surgeons are still trying to expand the applications of this technique. Parallel to the development of new techniques, we are also measuring the presentation of new complications. Incisional hernias are not new complications. Although their avoidance has been one of the proposed benefits of laparoscopy, several cases of port-site hernias have been reported. Current surgical wisdom suggests closure of 10-mm or larger port sites to avoid herniation. Most surgeons do not routinely close 5-mm port sites, believing that such fascial defects are not large enough to create a significant risk of hernia formation, thus not justifying the extra time and effort needed to close them. Although this practice may be reasonable for most cases, it should be reconsidered in lengthy procedures, particularly if the port has been used for active operative instruments. Under these circumstances, the repetitive motions in different directions may cause the 5-mm defect to enlarge significantly, allowing a hernia of considerable size to develop, with the obvious clinical implications of such a complication. We present a case of a hernia through a 5-mm port site presenting as small-bowel obstruction in the early postoperative period after a laparoscopic paraesophageal hernia repair.
AB - A decade has passed since laparoscopy became a popular tool in general surgery. New technologies continue to surface, and surgeons are still trying to expand the applications of this technique. Parallel to the development of new techniques, we are also measuring the presentation of new complications. Incisional hernias are not new complications. Although their avoidance has been one of the proposed benefits of laparoscopy, several cases of port-site hernias have been reported. Current surgical wisdom suggests closure of 10-mm or larger port sites to avoid herniation. Most surgeons do not routinely close 5-mm port sites, believing that such fascial defects are not large enough to create a significant risk of hernia formation, thus not justifying the extra time and effort needed to close them. Although this practice may be reasonable for most cases, it should be reconsidered in lengthy procedures, particularly if the port has been used for active operative instruments. Under these circumstances, the repetitive motions in different directions may cause the 5-mm defect to enlarge significantly, allowing a hernia of considerable size to develop, with the obvious clinical implications of such a complication. We present a case of a hernia through a 5-mm port site presenting as small-bowel obstruction in the early postoperative period after a laparoscopic paraesophageal hernia repair.
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U2 - 10.1089/lap.1999.9.523
DO - 10.1089/lap.1999.9.523
M3 - Article
C2 - 10632516
AN - SCOPUS:0033427603
VL - 9
SP - 523
EP - 525
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
SN - 1092-6429
IS - 6
ER -