Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2013, Vol. 09 ›› Issue (06): 740 -743. doi: 10.3877/cma.j.issn.1673-5250.2013.06.005

Special Issue:

Original Article

The Analysis of Bowel Hernia Following Laparoscopic Surgery in Gynecology

Wei WANG1, Shan-de YIN1(), Ai-ming WANG1, Mu-jia ZHANG1, Ming-kai WANG1   

  1. 1. Department of Obstetrics and Gynecology, Navy General Hospital of PLA, Beijing 100048, China
  • Received:2013-06-20 Revised:2013-11-06 Published:2013-12-01
  • Corresponding author: Shan-de YIN
  • About author:
    (Corresponding author : YIN Shan-de , Email : )
Objective

To explore the characteristic of trocar site hernia following gynecological laparoscopic surgery and the preventive methods.

Methods

A total of 1 891 cases of clinical data after laparoscopic surgery in our hospital from July 2008 to April 2013 were analyzed retrospectively. The characteristics and high risk factors of bowel hernia were discussed. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Navy General Hospital of PLA. Informed consent was obtained from each participating patient.

Results

Two cases of bowel hernia were both occurred in the left lower abdominal port site, by which specimens were taken. The diameter of trocar site were 15 mm and 10 mm. Five and four days delayed after surgery. The incidence of bowel hernia after laparoscopic surgery was 0. 1 % (2/1 891) in our department, that was 0. 3 % (1/367) after laparoscopic myomectomy and 1. 9 % (1/52) in elderly women patients.

Conclusions

The key to prevent intestinal hernia after laparoscopic surgery is that suturing peritoneum carefully, especially in elderly women patients and the patients with trocar site bigger than 10 mm. Suturing peritoneum under laparoscopic visualization would prevent the hernia effectively.

图1 病例1左下腹穿刺孔肠管嵌顿
Figure 1 Trocar site hernia in left lower abdomen of the case 1
图2 病例2左下腹穿刺孔肠管嵌顿
Figure 2 Trocar site hernia in left lower abdomen of the case 2
图3 病例2解除肠管嵌顿后腹腔镜下缝合腹膜
Figure 3 Laparoscopic suturing peritoneum after relieving bowel impaction of the case 2
表1 本院妇科腹腔镜术后肠疝危险因素分析
Table 1 The risk factors of bowel hernia following laparoscopic surgery in our department
1
Hitoshi Tonouchi, Yukinari Ohmori, Minako Kobayashi, et al. Trocar site hernia[J]. ARCH SURG,2004,139(11) : 1248-1256.
2
Lan AQ, Wang DX, Xu P. 53 cases of laparoscopic surgery complications[J]. J Guangxi Med Univ,2010, 27(6) : 918-919.
3
Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy : A survey of the American Association of Gynecologic Laparoscopic[J]. Obstet Gynecol, 1994,84:881-884.
4
Nezhat C, Nezhat F, Seidman DS,et al. Incisional hernias after operative laparoscopy [J]. Laparoendosc Adv Surg Tech A, 1997, 7:111-115.
5
Kadar N, Reich H, Liu CY, et al. Incisional hernias after major laparoscopic gynecologic procedures [J]. Am J Obstet Gynecol, 1993,168:1493-1495.
6
Gunderson CC, Knight J, Ybanez-Morano J, et al. The risk of umbilical hernia and other complications with laparoendoscopic single-site surgery[J]. J Minim Invasive Gynecol,2012,19 (1): 40-45.
7
Boike GM, Miller CE, Spirtos NM, et al. Incisional bowel herniations after operative laparoscopy: A series of nineteen cases and review of the literature[J]. Am J Obstet Gynecol, 1995,172 (6):1726-1731.
8
Moreaux G, Estrade-Huchon S, Bader G,et al. Five-millimeter trocar site small bowel eviscerations after gynecologic laparoscopic surgery[J]. J Minim Invasive Gynecol,2009 ,16(5) : 643-645.
9
Khurshid N, Chung M, Horrigan T, et al. 5-millimeter trocar-site bowel herniation following laparoscopic surgery[J]. JSLS,2012,16 (2):306-310.
10
Chiu CC, Lee W, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations[J]. Oes Surg,2006,16 : 913-918.
11
Lasheen AE, Elzeftawy A, Ahmed AH, et al. Anatomical closure of trocar site by using tip hole needle and redirecting suture hook [J]. Surg Endosc, 2010,24:2637-2639.
12
Thevissen P, Piera A. Laparoscopic fascia closure with the Carter-Thomason instruments[J]. Chirurg,1996,67(7) : 757-759.
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