A rare complication in the late period after laparoscopic sleeve gastrectomy: Small bowel incarceratıon.


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Akay T., Leblebici İ. M.

1. International Congress of Multidisciplinary Studies in Health Sciences, İstanbul, Türkiye, 3 - 05 Haziran 2020, ss.97-102

  • Basıldığı Şehir: İstanbul
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.97-102

Özet

Introduction: Laparoscopic sleeve gastrectomy is an obesity surgery performed in morbidly obese patients

with a body mass index of 40 or more. After sleeve gastrectomy, various complications can occur. Late port

site hernia is a rare complication seen in laparoscopic sleeve gastrectomy.

Case Report: A 47-year-old woman underwent laparoscopic sleeve gastrectomy operation a year ago. In the

last 2 weeks of the patient, there is a 5 cm irreducible hernia defect in the area where the port scar tissue (the

location of the resected stomach is removed) in the upper right abdomen of the abdomen. After abdominal

tomography was performed, the jejunum loop and omentum majus, which entered the hernia defect, were

removed and the hernia defect was repaired laparoscopically with composite mesh. The patient who was

discharged on the second day of postop was uneventful for 3 months.

Discussion and Conclusion: Technical factors and patient-related factors are among the risk factors of port

site hernia. Among the patient's factors, chronic bronchitis, obesity, old age, malnutrition, wound infection,

diabetes, pre-existing umbilical hernia are only a few of them. Technical factors include port diameter, port

design, port location, wound extension, defects during fascia closure, operation time, decompression of

pneumoperitoneum. In retrospective studies, it was suggested to close the port areas larger than 10 mm,

especially in the midline, and in prospective studies, the port location showed that the incidence of hernia was

more than expected, but many of these patients were not symptomatic. In this area where randomized

controlled trials are not performed adequately and long-term follow-up is inadequate, it is known to have

difficulty in closing port sites during obesity surgery. As a result, it is necessary to be diagnosed without delay

in patients presenting with herniation in the port region in the late period after laparoscopic sleeve gastrectomy

operation and it is aimed to operate laparoscopically without progressing to mechanical intestinal obstruction

strangulation.

Keywords: Obesity; Incisional; Hernia; Port; Laparoscopy.