Strangulated small bowel obstruction complicating totally extra-peritoneal laparoscopic inguinal hernia repair

Abstract

Totally extraperitoneal (TEP) laparoscopic inguinal hernia repair is a surgical method of inguinal hernia repair that avoids entry into the peritoneum, thus significantly reducing likelihood of intra-peritoneal complications. Herein, we describe a rare case in which a 42-year-old man presented with acutely strangulated small bowel in an internal hernia through the peritoneum and posterior rectus sheath 6 days postelective TEP laparoscopic inguinal hernia repair. He presented with acute onset severe abdominal pain and intractable vomiting. After CT diagnosis, emergent laparotomy was performed, and 20 cm of non-viable small bowel required resection, with enteric anastomosis. The peritoneal defect was identified and repaired. The patient was discharged 4 days postoperatively with an uneventful postoperative course.

Intestinal obstruction after totally extraperitoneal bilateral inguinal hernia repair: an infrequent complication in the early postoperative period

“…Pese a ser tan infrecuente, debe sospecharse esta complicación ante un cuadro de íleo intestinal posoperatorio tras hernioplastia inguinal TEP en la que haya podido producirse apertura del peritoneo durante la ejecución de la técnica 12 y actuar lo antes posible 13 .…”

“…Dado que el origen es una brecha peritoneal desapercibida durante el trascurso de la cirugía, el espacio preperitoneal debe examinarse antes de la eliminación del trocar de la cámara, así como vaciar por completo el gas de dicho espacio 12 .…”

Outcomes of laparoscopic repair in complicated groin hernia: A single institutional based cohort study in Nepal

“…Trans-abdominal preperitoneal [TAPP] and totally extra-peritoneal [TEP] approaches are the two most accepted techniques for laparoscopic repair of groin hernias. Complicated groin hernia [irreducible, obstructed, strangulated and incarcerated] is a common surgical emergency [ 1 ].Laparoscopic operations offer the advantages of rapid postoperative recovery and reduced hospital stay [ 2 ].Laparoscopic hernia repair in the elective setting has been shown to have comparable recurrence rate with less persisting pain and numbness as well as quicker return to usual activities when compared with open mesh repair [ 3 ].However, complicated groin hernia has traditionally been seen as a relative contraindication for laparoscopy approaches due to technical difficulties with regards to reduction of the incarcerated hernia contents, increased risk for iatrogenic injuries and increased morbidity.…”

Changes of pro- and antioxidant indicators in experimental animals under acute small bowel obstructions

“…Hypoxia in the wall of the small intestine leads to destructive processes in the mucous membrane of the intestinal epithelium, which are initially manifested by vascular disorders, edema and plethora of the mucous membrane, a sharp expansion in it of capillaries and venules, along with aggregation of blood elements. Subsequently, the destruction of the mucous membrane and other layers of the intestinal wall follows [ 2 ].…”