Herniation of the Small Bowel through the Port Site following Removal of Drains during Laparoscopic Surgery

Abstract

BACKGROUND/AIMS: Generally, the port site is used as the delivery route for drainage after laparoscopic abdominal surgery. We report this case because of the rarity of the complication related to laparoscopic procedures. METHODS: A 75-year-old woman underwent a laparoscopic-assisted sigmoid colectomy for early stage cancer. RESULTS: After the operation, her postoperative course was uneventful. However, just after removing the drains, the small bowel was found to have herniated through the port site used as the insertion route for the drains. An emergency relaparotomy was done and a segment of the necrotic small bowel had to be resected. CONCLUSION: To prevent this complication, we suggest that, first of all, in elderly and thin patients smaller trocar insertion sites (<10 mm) should be utilized as insertion routes for the drains and, secondly, the fascial defect should be closed just after removing the drains whenever the defect measures 10 mm or more in size.