Laparoscopic repair of sciatic ureteral hernia: A case report.
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SUBMITTER: Grbic D
PROVIDER: S-EPMC8649727 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAcquired perineal hernia is a rare complication following extensive pelvic surgery. Radiotherapy is also a predisposing factor. Perineal hernia can cause chronic perineal pain, bowel obstruction, urinary disorders and a cosmetically disfiguring defect. The treatment of perineal hernia is surgical, usually consisting of mesh repair via an abdominal or perineal approach.Case presentationWe present a case report and a surgical video of a 42-year-old woman with history of a squamous cell carcinoma. This patient had 3 recurrences since the diagnosis and a symptomatic perineal hernia. Complete regression of the recurrent malignancy allowed us to treat the perineal hernia. We performed laparoscopic repair with prosthetic mesh in this patient who had undergone multiple surgeries and radiotherapy, while preserving the omental flap that was used to reconstruct the posterior part of the vagina.ConclusionThere is no consensus concerning the preferred surgical approach, perineal or laparoscopic, as no study has demonstrated the superiority of either of these approaches. Laparoscopic repair for an acquired perineal hernia is safe and feasible. However, further studies including randomized trials are required to precisely evaluate the best surgical approach and type of mesh.
| S-EPMC8132409 | biostudies-literature
Project description:Obturator hernias are rare hernias with high morbidity and mortality if not diagnosed and treated promptly. Various minimally invasive techniques have been reported in literature. Here we describe a novel technique of repairing an obturator hernia complicated by small bowel incarceration and obstruction, via a laparoscopic trans-abdominal approach.
| S-EPMC7334541 | biostudies-literature
Project description:IntroductionRepair of supra-pubic incisional hernia is still challenging because of the highest pressure at the lower abdominal wall in the erect position. Recently, laparoscopic preperitoneal mesh repair has been gradually reported.Case presentationA 77-year-old woman underwent single-incision laparoscopic preperitoneal mesh repair under a diagnosis of a supra-pubic incisional hernia, measuring 7 × 4 cm. A single, 2.5-cm, intraumbilical incision was made, followed by creation of the preperitoneal space. Then, the posterior rectus sheath and peritoneum were opened, and laparoscopic exploration was performed. After dissection of the supra-pubic hernia content, the tube for degassing the abdominal cavity was inserted into the abdominal cavity, and the peritoneum and the posterior sheath were closed. The preperitoneal space was dissected gradually, and circular dissection of the hernia sac was performed. The proximal sac (peritoneum) was sutured continuously. A 15 × 10 cm mesh was placed in the preperitoneal space and fixed securely with absorbable tacks at the pubic bone, Cooper's ligament, and the rectus abdominis muscle, respectively. After degassing the preperitoneal space, a second laparoscopic exploration was performed to confirm the secure suture of the peritoneum and no injury of the abdominal organs. At 4-month follow-up, the patient remained well with no signs of recurrence.DiscussionSingle-incision laparoscopic preperitoneal mesh repair could minimize the recurrence of supra-umbilical incisional hernia and perioperative complications.ConclusionSingle-incision laparoscopic preperitoneal mesh repair, offering good cosmetic results, might be useful for repair of supra-pubic incisional hernia.
| S-EPMC6139388 | biostudies-literature
Project description:Introductionand importance: We report a case of a patient who developed early peritoneal metastasis after laparoscopic incisional hernia repair secondary to curative colon cancer resection.Case presentationA 77-year-old woman underwent ileocecal resection with open laparotomy for locally advanced cecal cancer. The pathological diagnosis was adenocarcinoma with T3N2aM0. Three months after the surgery, she developed incisional hernia at the midline incision site. After the completion of adjuvant chemotherapy, surveillance computed tomography (CT) showed no cancer recurrence. Her abdominal discomfort persisted because of incisional hernia, and thus we performed laparoscopic incisional hernia repair using the intraperitoneal onlay mesh technique at 11 months after the initial surgery.Five months after incisional hernia repair, CT showed multiple liver and peritoneal metastases. She was started on systemic chemotherapy. Two days after the first therapeutic infusion, she developed small bowel obstruction. We decided to perform palliative surgery with intestinal bypass. Exploratory laparoscopy revealed that the implanted mesh for incisional hernia repair was completely covered with multiple nodules of peritoneal metastasis. Two months after the bypass surgery, she resumed her chemotherapy, but CT showed significant progression of all recurrent lesions. She did not wish to continue further chemotherapy and decided to receive the best supportive care.Clinical discussionThis case may raise important clinical questions regarding the indication and timing of incisional hernia repair for patients who are at high risk of cancer recurrence.ConclusionIncisional hernia repair must be performed in the absence of any possibility of cancer recurrence, particularly in the earlier follow-up period.
| S-EPMC8606881 | biostudies-literature
Project description:IntroductionObturator hernias account for less than 0.073% of all hernias and less than 1.6% of all cases of mechanical bowel obstructions.Presentation of caseWe present a case of a 79 year-old elderly female with two recurrent bowel obstructions that have resolved with conservative management. On the third presentation we performed a totally extraperitoneal repair (TEP) with conscious sedation and a L3/4 spinal block. An obturator defect was patched with a self gripping mesh (progrip). The patient was discharged day 2 post operatively.DiscussionLaparoscopic surgery can be safely performed in high risk patients with careful monitoring. Laparoscopic surgery is usually associated with a shorter post-operative length of stay.ConclusionThis case demonstrates the successful but unconventional repair of an obturator hernia in a patient who had a high risk of significant morbidity and mortality with a more conventional anaesthesia and surgery.
| S-EPMC6699463 | biostudies-literature
Project description:INTRODUCTION:Perineal hernia is a protrusion of the pelvic floor containing intra-abdominal viscera. The occurrence of postoperative perineal hernia after abdominoperineal resection (APR) is rare, but reports have indicated a recent increase in occurrence following surgical treatment for rectal cancer. This has been attributed to a shift towards extralevator abdominoperineal resection, together with more frequent and long-term use of neoadjuvant therapy. PRESENTATION OF CASE:Here, we report the case of a patient who underwent APR for cancer. Twenty months postoperative, a perineal hernia was detected. The patient was electively scheduled for surgery. Robot-assisted laparoscopy was performed using the da Vinci Surgical System. The perineal hernia was repaired by primary closure with the placement of Symbotex Composite mesh as reinforcement for the pelvic floor. The surgery was performed without any adverse events, and the patient was discharged the day after surgery. Clinical follow-up proceeded at the designated time intervals without difficulties. DISCUSSION:Recurrence rates of perineal hernia remain high, and surgeons face numerous challenges related to poor view, suturing and mesh placement in the deep pelvis. Numerous approaches have been described, but there is still no consensus as to the optimal repair technique for perineal hernia. CONCLUSION:Symptomatic perineal hernias can feasibly be repaired with robot-assisted laparoscopy. Furthermore, suturing and mesh placement require less effort with the robot approach when compared to the open and laparoscopic approaches. These promising findings are demonstrated in the included video.
| S-EPMC6351357 | biostudies-literature
Project description:BackgroundReduction en masse (REM) is a rare condition following manual inguinal hernia (IH) reduction in which a hernia sac is reduced back into the preperitoneal space with a loop of the bowel incarcerated at the neck of the sac. It resembles successful manual reduction and may thus be overlooked easily. We herein report an infantile case of REM of an IH that was successfully treated laparoscopically.Case presentationA 10-month-old boy with a surgical history of bilateral open IH repair at 4 months old presented with a bulge in his left groin and vomiting. A left incarcerated recurrent IH was suspected, and manual reduction was performed. The hernia was apparently reduced successfully, but abdominal distention and vomiting persisted. He was admitted for further observation due to the symptoms. On day 2 after admission, abdominal X-ray showed extensive small bowel obstruction (SBO). Enhanced computed tomography (CT) revealed protrusion of the small bowel with a closed-loop in the left groin. A closed-loop SBO due to postoperative adhesion or an internal hernia was suspected. To assess the etiology of SBO, emergent laparoscopic exploration with hernia repair was planned. Laparoscopy revealed REM of the left incarcerated IH with a thickened peritoneum at the neck of the sac. Laparoscopic reduction was performed, and the incarcerated small bowel showed no signs of ischemia. The hernia sac was not associated with the previously ligated processes vaginalis, which had been closed by a previous Potts' procedure. It was located at the inside of the processes vaginalis. The sac was successfully closed by laparoscopic percutaneous extraperitoneal closure procedures, and iliopubic tract repair was also performed via the previous inguinal incision. The postoperative course was uneventful.ConclusionPediatric IH is due to the patent processes vaginalis, and REM is extremely rare. Laparoscopic surgery for REM is a relatively common and useful approach for the diagnosis and treatment of adults. In our infantile case, the laparoscopic approach was similarly effective for both investigating the cause of SBO and performing high ligation of the sac for this rare condition with IH.
| S-EPMC9512946 | biostudies-literature
Project description:BackgroundA diaphragmatic hernia is a prolapse of the abdominal organs into the thoracic cavity through a hole in the diaphragm. Traumatic diaphragmatic injuries are rare and usually occur after blunt or penetrating thoracic or abdominal traumas. Blunt diaphragmatic rupture rarely accounts for immediate mortality and may go clinically silent until complications occur which can be life threatening. It usually present late with intrathoracic herniation of abdominal viscera and carry a high mortality rate. We experienced a very rare case who showed repeated colon incarcerations 7 years after injury. And, we operated laparoscopically.Case presentationA 64-year-old man presented with multiple left rib fractures that occurred during an accident. After 7 years, he visited the emergency department with the chief complaint of left shoulder pain and epicardial pain after eating. He was diagnosed with transverse colon incarceration due to a left diaphragmatic hernia by computed tomography (CT) and X-ray imaging. Surgical repair was recommended, but he refused as the symptoms improved. Fourteen months later, the patient revisited the hospital in similar symptoms and improved spontaneously. He consulted our hospital for the surgical indication. We recommended that he undergo surgery, showing images of the X-ray and CT when his transverse colon was obstructed and he felt pain and when symptoms improved. Finally, he decided to undergo surgery. We performed diaphragmatic hernia repair with laparoscopic direct suturing in good view. The patient experienced an uneventful postoperative recovery period. The absence of diaphragmatic herniation recurrence was confirmed seven months after surgery.ConclusionsWe experienced a traumatic diaphragmatic hernia with repeated colon incarcerations 7 years after injury and performed surgical repair laparoscopically.
| S-EPMC10710970 | biostudies-literature
Project description:Video 1Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 2Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 3Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 4Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 5Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 6Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 7Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 8Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 9Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 10Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.Video 11Video available at: https://www.jtcvs.org/article/S2666-2507(21)00514-9/fulltext.
| S-EPMC8691125 | biostudies-literature
Project description:Laparoscopic intraperitoneal onlay mesh (IPOM) repair is occasionally used for inguinal hernia repair. Here, we report a case of chronic neuropathic pain after laparoscopic IPOM repair for inguinal hernia, which was treated successfully with laparoscopic selective neurectomy.A 59-year-old man with bilateral inguinal hernia underwent laparoscopic repair. Transabdominal preperitoneal repair was performed on the left side, whereas IPOM repair was performed on the right side due to a peritoneal defect. At postoperative month 1, he presented with severe pain and numbness distributed from the right inguinal region to the inner thigh region. The symptoms had persisted for 1year despite medical treatment. We diagnosed that the symptoms might be due to the entrapment of nerves in the contracted mesh, and performed a second surgery via laparoscopic approach 13 months after the first surgery. On laparoscopic exploration, the lateral side of the mesh was contracted and involved nerve branches. We ligated and cut off these nerve branches. His symptoms resolved immediately after the surgery. At postoperative month 12, he has passed without any pain, numbness, and hernia recurrence.Laparoscopic exploration would be useful to figure out chronic neuropathic pain after laparoscopic inguinal hernia repair.Laparoscopic IPOM repair for inguinal hernia should be avoided as much as possible because it may cause chronic neuropathic pain. Laparoscopic selective neurectomy is an option for patients with chronic neuropathic pain after laparoscopic hernia repair.
| S-EPMC5536818 | biostudies-other