Small bowel obstruction in a peritoneal defect after laparoscopic burch procedure

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With expansion of laparoscopic surgery, the gynecologic surgeon faces a new set of complications not encountered in open surgery and completely related to the laparoscopic approach. A rare complication occurred after laparoscopic Burch colposuspension performed in a patient with genuine stress urinary incontinence. Although the fascial incision at the right lower quadrant cannula insertion site was closed, a loop of small bowel herniated through the nonclosed peritoneal defect and caused intestinal obstruction 9 days after surgery. For cannula insertion sites 10-mm and greater, we recommend suturing peritoneal defects at the time of fascial closure.