Management of intestinal obstruction following laparoscopic donor nephrectomy

Abstract

Internal hernias are a rare cause of small bowel obstruction. Following laparoscopic bariatric surgery, specifically gastric bypass and laparoscopic colonic resections, there has been an increase in the incidence of internal hernias. This has been due to either a mesenteric or mesocolic defect being not closed or completely missed. Small bowel loops usually herniate through these defects and present as intestinal obstruction. Internal hernia following laparoscopic donor nephrectomy is a rare complication. The need for presenting this case is the rarity of its occurrence, to stress the fact that following major abdominal laparoscopic surgery the mesenteric or mesocolic defects should be closed, and that this complication was managed laparoscopically, through the same port sites as used earlier for the donor nephrectomy.

Transmesenteric Internal Herniation Leading to Small Bowel Obstruction Postlaparoscopic Radical Nephrectomy

“…It is unclear however whether or not this case was converted into open surgery. The case described by Wadhawan et al is managed entirely laparoscopically [ 9 ]. In this case the hernia is reduced following dissection of the small bowel from the tail of the pancreas.…”

Large bowel obstruction due to adhesion bands following right nephrectomy and transplanted pelvic kidney

“…There are several cases in the literature describing post‐operative adhesion bands which have led to a LBO; however, there are no such cases related to a nephrectomy or renal transplant. There are several cases which report an intestinal obstruction following laparoscopic nephrectomy, several of which involve mesenteric herniation of small bowel . There are cases reported of adhesion bands causing LBO following appendicectomy, laparoscopic converted to open inguinal hernia repair and laparoscopic cholecystectomy …”