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Updates in Surgery

, Volume 70, Issue 1, pp 151–152 | Cite as

A 5-mm trocar site paramedian early onset voluminous hernia: still in doubt?

  • Antonio Pellegrino
  • Gianluca Raffaello Damiani
  • Giuseppe Trojano
  • Massimo Stomati
Letter to the Editor
  • 42 Downloads

Dear Editor,

With the increasing number of laparoscopies in abdominal surgery, more incisional trocar site hernias (ITH) are observed. Tonouchi et al. have classified trocar-site hernias into three types: early onset, late onset and special [1]. In most cases, the ITH had an early onset, occurring within the first week along with intestinal obstruction caused by ileal loop incarceration (Richter’s hernia).

The case presented herein is of a 5-mm early onset ITH. The patient after a laparoscopic total hysterectomy with bilateral annessiectomy and peritoneal biopsies for an ovarian mucinous tumor of 14 cm was discharged on the third postoperative day. At the tenth postoperative day, she arrived at the emergency department, with pain in the left side, in which was observed an ITH of the small intestine with hemorrhagic infarction due to venous congestion. The patient was afebrile, without nausea and vomiting. Laboratory parameters were normal, except value of C-reactive protein, that...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The informed consent was obtained.

References

  1. 1.
    Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M (2004) Trocar site hernia. Arch Surg 139:1248–1256CrossRefPubMedGoogle Scholar
  2. 2.
    Kadar (1993) Incisional hernias after major laparoscopic gynecologic procedures. Am J Obstet Gynecol 168(5):1493–1495CrossRefPubMedGoogle Scholar
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    Nezhat C (1997) Incisional hernias after operative laparoscopy. J Laparoendosc Adv Surg Tech A 7(2):111–115CrossRefPubMedGoogle Scholar
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    Yamamoto M, Minikel L, Zaritsky E (2011) Laparoscopic 5-mm trocar site herniation and literature review. JSLS 15(1):122–126CrossRefPubMedPubMedCentralGoogle Scholar
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    Montz FJ, Holschneider CH, Munro MG (1994) Incisional hernia following laparoscopy: a survey of the American Association of Gynaecologic Laparoscopists. Obste Gynecol 84:881–884Google Scholar

Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyASTT LECCO, Ospedale Alessandro ManzoniLeccoItaly
  2. 2.Department of Obstetrics and GynaecologyUniversity of Bari Aldo MoroBariItaly
  3. 3.Unit for Obstetrics and gynecologyFrancavilla fontana hospitalFrancavilla fontanaItaly

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