V-037 LAPAROSCOPIC REPAIR OF FORAMEN OF WINSLOW HERNIA CONTAINING THE RIGHT COLON

Abstract

Abstract Aim A 74-year-old woman with hypothyroidism, dyslipidaemia and past abdominal surgeries presented with severe abdominal pain, nausea, bloating and anorexia. On clinical examination, the abdomen was soft with tenderness on palpation in the epigastrium. The laboratory workup revealed leukocytosis. Abdominal CT showed the caecum, the ascending colon, and the hepatic flexure herniated in the lesser sac through the Foramen of Winslow. Even though the initial plan was conservative management, the hernia was persistent and not resolving in the repeat CT scan. A decision was made to proceed with laparoscopic exploration. We aim to present a video of a laparoscopic repair of a Foramen of Winslow hernia. Material and methods Laparoscopy revealed free intrabdominal fluid and part of the right colon in the lesser sac. The hernia was reduced manually, and the colon was inspected, revealing no signs of ischemia. As the caecum was very mobile, a caecopexy was performed by suturing the cecum and the ascending colon to the lateral abdominal wall using non-absorbable interrupted sutures. The operation was performed with three ports, a 10 mm infraumbilcal port for the scope and two 5 mm ports in the right lower quadrant of the abdomen. Results Recovery was uneventful, and the patient was discharged the following day. In follow-up, pain and bloating had completely resolved, and her quality of life was significantly improved. Conclusions This was a challenging case from the technical and the decision-making point of view, with a good outcome and no complications.