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We report a case of postoperative bowel obstruction with early onset hernia presenting through a 5-mm port. A 43-year-old woman having undergone laparoscopic ovarian cystectomy 2 days before presented with features of intestinal obstruction in the form of persistent abdominal pain, vomiting, and inability to pass stool or flatus. Computed tomography scan of her abdomen showed collapsed large bowel and a loop of small bowel protruding through the lateral 5-mm sheath defect. A secondary laparoscopic procedure allowed both confirming diagnosis and surgical repair of the hernia. Our case describes this rare complication through a 5-mm lateral port, with complete bowel obstruction, in the absence of any of the recognized risk factors following a straightforward short surgical procedure, performed as an open laparoscopy with the sample retrieved through the 10-mm trocar. Body mass index was normal, with no significant health problems preoperatively.

A 38-year-old lady with a 14×8×13-cm dermoid cyst underwent a laparoscopic left salpingo-oophrectomy.

INTRODUCTION: The target was to determine the effect of using internal iliac artery balloon catheterization (IIABC) in morbidly adherent placenta previa on surgical outcomes during cesarean section. METHODS: A retrospective comparative study was conducted from January 2013 till Oct 2016. From 67 women with morbidly adherent placenta during this time period- 33 underwent IIBAC before cesarean section (study group) and 34 underwent cesarean section without (control group). The outcomes measured were intra-operative blood loss, units of blood transfusion, loss in hemoglobin and hematocrit, total operative time, hemostatic medications and surgical procedures used, and the duration of hospital stay. RESULTS: The demographics were comparable, with no difference in maternal age (P=1), nationality (P=.86), BMI (P=.8), parity (P=.26), gestation (P=.31), pre-op hemoglobin (P=.736) and maternal co-morbidities like anemia (P=.7), diabetes (P=.5) and hypertension (P=.08). No significant difference was noted in the mean intra-operative blood loss (3115±1745 vs. 3447±2352, P=.515), transfusion ≥-6 units (30.3% vs. 41.17%, P=.357), duration of hospital stay (6.18±3.32 vs. 5.61±3.48, P=.495), loss in hemoglobin (2.158±1.758 vs. 1.68±1.69, P=.26) and the use of medications and surgical procedures. The use of general anesthesia was more in the study group (P=.049), with no difference in the neonatal factors. CONCLUSION: The use of IIABC as a means to reduce the intra-operative maternal morbidity is questionable, since the evidence proving the benefit is limited. In this case series, there were no statistical difference in the hemorrhagic outcome between women in whom it was used.