Internal herniation following laparoscopic left hemicolectomy: an underreported event

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Avanish SaklaniAshraf G Masoud

Abstract

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. 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. 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). Laparoscopic left hemicolectomy carries a significant risk of internal herniation. Performing a laparoscopic subtotal colectomy or fashioning th...Continue Reading

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Citations

Jun 12, 2013·International Journal of Colorectal Disease·Nabila AnsariGillian L Richardson
May 23, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A P SaklaniA G Masoud
Jun 3, 2014·World Journal of Surgical Oncology·Yuichiro YokoyamaToshiaki Watanabe
Sep 3, 2016·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S Y LeeH R Kim
Jul 22, 2016·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J W T TohM J F X Rickard
Nov 21, 2017·Polski przeglad chirurgiczny·Melina SvrakaOrhan Bulut
Nov 23, 2019·Techniques in Coloproctology·Mohammad Faraz KhanRonan A Cahill
Oct 10, 2012·Diseases of the Colon and Rectum·Kirk A Ludwig, Lauren Kosinski
Jun 1, 2017·Journal of Surgical Case Reports·Hiroki SugitaMasahiko Hirota
Oct 26, 2018·BioMed Research International·Kai-Lung TsaiHong-Hwa Chen
Jan 10, 2018·ANZ Journal of Surgery·François Rouleau-FournierPhilippe Bouchard

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