Richter's hernia after an intraperitoneal mesh repair

Asian J Endosc Surg. 2014 Nov;7(4):330-3. doi: 10.1111/ases.12124.

Abstract

For ventral hernia repair, laparoscopic surgery offers various advantages, including the application of a large mesh using the intraperitoneal approach. However, improper closure of the port site may lead to serious complications. Port-site hernia is a rare outcome of inadequate repair of the fascial or peritoneal layer, and Richter's hernia in a high risk patient, in the presence of an intraperitoneal mesh, is a particularly challenging scenario. Herein, we present a 58-year-old woman who, after a ventral hernia repair, was diagnosed with a small bowel hernia through a 10-mm port site. The patient complained of pain and mild swelling at the port site in the postoperative period, and her symptoms indicated intestinal obstruction. Clinical evaluation and abdominal X-ray confirmed the diagnosis, and early laparoscopic re-exploration and management were the key to a favorable outcome.

Keywords: Laparoscopic intraperitoneal repair; Richter's hernia; ventral hernia.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Hernia, Ventral / etiology
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / instrumentation
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy*
  • Middle Aged
  • Peritoneum / surgery
  • Reoperation
  • Surgical Mesh*