Abstract
Introduction and importanceInguinal hernia repair is a very frequent operation in general and visceral surgery worldwide. The laparo-endoscopic approaches such as TAPP have gained increasing acceptance among specialists and many consider them as standard of care due to perioperative safety and excellent postoperative results. Knowledge of specific complications after minimally invasive inguinal hernia surgery, however, is important for the successful management of these patients.Case presentationWe herein present the case of a 75-year-old female patient who electively underwent laparoscopic repair of combined inguinal and femoral hernia. During the postoperative course a small bowel obstruction occurred requiring emergency re-laparoscopy revealing a preperitoneal herniation of small bowel through a peritoneal defect.Clinical discussionSmall bowel obstruction due to preperitoneal herniation of small bowel through a peritoneal defect after laparoscopic hernia repair is extremely rare. In such cases, emergency laparoscopic revision is necessary to avoid bowel ischaemia. Adequate closure of the peritoneum during the primary procedure along with the necessary attention to detail seems mandatory to avoid preperitoneal herniation after TAPP.ConclusionInadequate peritoneal closure after TAPP may lead to preperitoneal herniation of the small bowel leading to postoperative intestinal obstruction. All hernia surgeons should be aware of this rare, but potentially life-threatening complication and should close all peritoneal defects with greatest care and accuracy.
Highlights
Introduction and importanceInguinal hernia repair is a very frequent operation in general and visceral surgery worldwide
Laparo-endoscopic techniques like the transabdominal preperitoneal patch plasty (TAPP) have fundamentally changed the surgical treatment of inguinal hernias and are characterized by less post-operative pain, faster recovery, a shorter hospital stay, better cosmesis, easier repair of recurrent hernias, and the ability to treat bilateral hernias concurrently when compared to conventional techniques such as the Lichtenstein- or Shouldice procedure [1]
We describe the rare complication of small bowel obstruction due to preperitoneal herniation of a loop of small intestine following elective laparoscopic TAPP for inguinal hernia repair
Summary
Laparo-endoscopic techniques like the transabdominal preperitoneal patch plasty (TAPP) have fundamentally changed the surgical treatment of inguinal hernias and are characterized by less post-operative pain, faster recovery, a shorter hospital stay, better cosmesis, easier repair of recurrent hernias, and the ability to treat bilateral hernias concurrently when compared to conventional techniques such as the Lichtenstein- or Shouldice procedure [1]. Small bowel obstruction (SBO) represents such a rare complication after TAPP and has been reported to occur in approximately 0.1–0.3% of cases [2,3]. Among the potential causes of SBO after TAPP is a preperitoneal her niation of small bowel through a peritoneal defect [4]. We report the case of a 75-year-old female with a preper itoneal herniation of small bowel leading to a mechanical obstruction shortly after TAPP for treatment of a combined inguinal and femoral hernia. This case report has been written in line with the SCARE Criteria [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
