title: Laparoscopic repair of bowel herniation through previous cannula insertion sites.
abstract: Operative laparoscopy frequently requires large cannulas below or above the umbilicus, which may result in unusual complications such as small bowel herniation through these insertion sites. Three women experienced small bowel herniation through cannula incision sites, either extraumbilically or paraumbilically, after major laparoscopic surgery. Two patients who had undergone laparoscopic myomectomy developed small bowel herniation through the 12-mm extraumbilical cannula site on postoperative days 7 and 8, respectively. In the first woman, the nontender, palpable, and reducible herniation healed spontaneously, with no episode of herniation during follow-up. The second patient required laparoscopic reduction of the herniated loop and repair of the fascial defect. The last woman had undergone laparoscopic-assisted vaginal hysterectomy and developed small bowel herniation through an unrecognized fascial defect paraumbilically 3 days postoperatively. Intended repair by laparoscopy was changed to laparotomy due to extensive and incarcerated bowel herniation.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Medical School, Linkou Medical Center, 5 Fu-Hsing Street, Kwei-Shan, Tyo-Yuan, Taiwan 10591, Republic of China.
authors.forename: F H
authors.initials: FH
authors.lastname: Chang
authors.forename: Y K
authors.initials: YK
authors.lastname: Soong
authors.forename: P J
authors.initials: PJ
authors.lastname: Cheng
authors.forename: H H
authors.initials: HH
authors.lastname: Chou
authors.forename: C L
authors.initials: CL
authors.lastname: Lee
authors.forename: Y M
authors.initials: YM
authors.lastname: Lai
authors.forename: F R
authors.initials: FR
authors.lastname: Hwang
authors.forename: K K
authors.initials: KK
authors.lastname: Chu
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery; D000328:Adult; D002404:Catheterization / Q000295:instrumentation; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D012075:Remission, Spontaneous; D014472:Umbilicus / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery