A Case of Incarcerated Port Site Hernia under the Fascia after Closing the Fascia

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 79; no. 8; pp. 1794 - 1797
• Main Authors: KURATA, Shuji, SAWAMURA, Naoki, BAN, Takushirou, KOHRIKI, Shunsaku, TANEMURA, Hiroyuki, NAKAZAKI, Haruhiro
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2018
• Subjects: laparoscopic surgery; port site hernia; under the fascia
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.79.1794

A 63-year-old woman underwent sigmoidectomy with D3 lymph node resection for colon cancer. At the end of the operation, a 5-mm port drain was inserted in the lower left abdomen. The drain was withdrawn on the seventh postoperative day. She started to complain of abdominal pain, vomiting, and bulging at the site of the 12-mm port incision in the lower right abdomen. Abdominal computed tomography (CT) showed bowel obstruction due to incarceration of the small intestine at the site of the 12-mm incision port in the lower right abdomen. An urgent operation with a diagnosis of port site hernia was performed. First, the aponeurosis of the abdominal oblique muscle was tightly sutured. After the aponeurosis was opened, strangulated small intestine was observed in the free space under the aponeurosis. It was concluded that suturing of all abdominal wall layers including the peritoneum was necessary at the time of port site closure.