Internal Herniation Following Laparoscopic Left Hemicolectomy: An Underreported Event

Saklani, Avanish; Naguib, Nader; Tanner, Nicola; Moorhouse, Stephanie; Davies, Clare Elizabeth; Masoud, Ashraf G.
July 2012
Journal of Laparoendoscopic & Advanced Surgical Techniques;Jul/Aug2012, Vol. 22 Issue 6, p496
Academic Journal
Purpose: Laparoscopic colorectal surgery creates fewer adhesions compared with open colorectal resection. Small bowel obstruction after laparoscopic colorectal resection may be caused by internal herniation of the small bowel through a colomesenteric defect, probably related to a lack of adhesion formation. This is seen especially after left colonic resections. Methods: A literature review was conducted using the key words 'intestinal obstruction' and 'laparoscopic left colonic resection,' and 9 documented case reports of obstruction following laparoscopic left colorectal resection were identified. We present 2 additional cases and discuss the etiology, diagnosis, management, and possible options for avoiding this complication. Results: In total, 167 consecutive laparoscopic procedures were performed in our study, and 8 were left hemicolectomies. Four of these patients (50%) developed intestinal obstruction, with 2 requiring surgical intervention for internal hernia. For the remaining 159 colorectal procedures, there were only 2 admissions with intestinal obstruction, with 1 patient requiring surgery ( P=.006). Conclusions: Laparoscopic left hemicolectomy carries a significant risk of internal herniation. Performing a laparoscopic subtotal colectomy or fashioning the colocolonic anastomosis through the small bowel mesentery may minimize this risk.


Related Articles

  • Laparoscopic Repair of a Morgagni Hernia: Report of a Case and Review of the Literature. Contini, S.; Dalla, R.; Bonati, L.; Zinicola, R. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb99, Vol. 9 Issue 1, p93 

    Focuses on a case of an 85-year-old woman with subacute intestinal obstruction due to a large Morgagni hernia containing the tranverse colon. Overview of the laparoscopy performed on the woman; Purpose of the laparoscopic surgery made; Details on the Morgagni diaphragmatic hernia.

  • Port-Site Hernia Vs Spigelian Hernia: A Diagnostic Confusion. Akbar, Fayyaz; Tan, Melissa; Maw, Andrew // Internet Journal of Radiology;2008, Vol. 8 Issue 8, p10 

    Port site hernias are a recognized complication of laparoscopic surgery. There is an increasing trend towards laparoscopic colorectal resection. During such procedures a 10-12 mm port is often placed in the midclavicular line usually just below and lateral the level of umbilicus. If a port site...

  • Low Incidence of Adhesion-Related Bowel Obstruction After Laparoscopic Colorectal Surgery. Rosin, Danny; Zmora, Oded; Hoffman, Aviad; Khaikin, Marat; Bar Zakai, Barak; Munz, Yaron; Shabtai, Moshe; Ayalon, Amram // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2007, Vol. 17 Issue 5, p604 

    Background: Postoperative adhesions are a major cause of morbidity, accounting for approximately 5% of the readmissions of surgical patients. Bowel obstruction is attributed to adhesions in more than half of the cases, many of which are following colon and rectal surgery. Laparoscopic surgery...

  • Obstructing Internal Hernia Complicating Totally Extraperitoneal Inguinal Hernia Repair. Lodha, Kiran; Deans, Andrew; Bhattacharya, Panchanan; Underwood, John Weston // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jun98, Vol. 8 Issue 3, p167 

    Reports a case of an extraperitoneal laparoscopic hernia repair complicated by internal herniation of small bowel through an inadvertent peritoneal defect. Reason for the preference of laparoscopic inguinal hernia repairs; Discussion on intestinal obstruction or strangulation; Difficulty of the...

  • Overview of Nonrandomized Studies of Laparoscopic Hernia Repair. Horgan, Paul G. // Seminars in Laparoscopic Surgery;Dec1998, Vol. 5 Issue 4, p233 

    Laparoscopic techniques have become established in the field of general surgery. Whereas there is general agreement that laparoscopic cholecystectomy has advantages over the open surgical operation, laparoscopic herniorrhaphy or hernioplasty remains controversial. This report looks at a...

  • Preperitoneal herniation and bowel obstruction post laparoscopic inguinal hernia repair: case report and review of the literature. McKay, R. // Hernia;Oct2008, Vol. 12 Issue 5, p535 

    Laparoscopic inguinal hernia repairs, both transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP), are associated with peritoneal defects or tears. Nonclosure of the tears can lead to bowel obstruction. I present a case of an early (48 h) bowel obstruction related to a peritoneal...

  • Bilateral congenital anterior diaphragmatic hernia: a case report. Ninos, A.; Pierrakakis, St.; Stavrianos, V.; Papaioanou, G.; Ajiazi, A.; Iordanou, Ch.; Vagenas, P.; Vidali, M.; Douridas, G.; Setakis, N. // Hernia;Dec2006, Vol. 10 Issue 6, p525 

    The anteromedial diaphragmatic hernias of Morgagni and Larrey are the least common defects that occur in this organ. Simultaneous occurrence has been described but remains an absolute rarity. We herein present a case of this bilateral herniation with a unique presentation. The paper refers to...

  • Internal hernia and small bowel obstruction caused by a linear cutter staple at appendiceal stump following laparoscopic appendectomy. Petersen, Lindsay F.; Nally, Mary C.; Agos, Andrew; Petty, Kyle // Journal of Surgical Case Reports;Jan2014, Vol. 2014 Issue 1, p1 

    Commonly linear staplers are used to perform laparoscopic appendectomies. We report a case of a small bowel obstruction caused by a staple on the appendiceal stump creating an internal hernia <1 week after laparoscopic appendectomy. We discuss the available literature on bowel obstructions...

  • Short- and Long-Term Results of Open Versus Laparoscopic Appendectomy. Swank, H. A.; Eshuis, E. J.; Berge Henegouwen, M. I. Van; Bemelman, W. A. // World Journal of Surgery;Jun2011, Vol. 35 Issue 6, p1221 

    Background: Clinical advantages of laparoscopic appendectomy have been shown in numerous trials and reviews. Most of these advantages are small and of limited clinical relevance, while laparoscopic operation costs are reported to be higher. The present study compares short- and long-term results...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics