Laparoscopic Paracecal Hernia Repair

Abstract

The diagnosis and treatment of internal abdominal hernia usually require laparotomy. We report a case of preoperative diagnosis and laparoscopic repair of paracecal hernia. A 90-year-old woman was referred with features of a well-established small bowel obstruction (SBO). Computed tomography and a small bowel contrast examination showed a paracecal hernia. With the patient under general anesthesia, laparoscopic surgery was carried out with the use of pneumoperitoneum, and an easy reduction of the incarcerated intestinal loop was achieved by gentle traction of the intestine. The bowel was assessed for viability and showed no evidence of nonviability. The abnormal orifice in the paracecal region was observed. The orifice was closed with 3-0 PDS II (polydiaxonone) sutures laparoscopically. A laparotomy was avoided, and the patient recovered without significant complications. We conclude that laparoscopy can play a useful role in the treatment of internal hernia causing SBO when an obstructive lesion has been detected and decompression accomplished preoperatively.

Early laparoscopic treatment of an obstructed paracecal hernia in an octogenarian: A case report

“…On reviewing these three case reports [3,8,9] all were performed after several days of conservative treatment which had not responded, in comparison to our patient who was operated on within 24 hours. All the cases showed viable bowel upon reduction of the hernia and no resections were required.…”

Laparoscopic surgery for the diagnosis and treatment of a paracecal hernia repair: Report of a case

“…Of these, only two cases were reportedly diagnosed by the laparoscopic procedure. 2,3 Only one of these two cases was successfully treated by laparoscopic surgery and achieved a good postoperative course. 2 The other case was converted to open surgery in order to avoid injury to the small intestine.…”

“…2 The other case was converted to open surgery in order to avoid injury to the small intestine. 3 Laparoscopic surgery is therefore considered suitable for early diagnosis and minimally invasive treatment of paracecal hernias. Some studies have reported enlarging the opening pouch as well as closing the orifi ce in order to avoid recurrence of the hernia.…”

“…1 Although minimally invasive surgery for the diagnosis and treatment of paracecal hernias is effective in restoring bowel function and reducing postoperative hospitalization, few cases have been reported to date. 2,3 We herein present the case of a 43-year-old woman diagnosed to have a paracecal hernia, who was successfully treated by laparoscopic surgery.…”

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].…”