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Special type trocar-site hernia with evisceration of the appendix following laparoscopic repair of a perforated duodenal ulcer

机译:腹腔镜修复穿孔十二指肠溃疡的腹腔镜修复后特殊类型的套管针疝

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摘要

Trocar-site hernia is an uncommon complication of laparoscopic surgery and can be classified as early-onset, late-onset or special type. Special type hernias usually occur in the early postoperative period and result in evisceration of intra-abdominal contents through all layers of the abdominal wall without an overlying hernia sac. We present a case of special type herniation of the appendix through a 5-mm trocar site in the right iliac fossa following laparoscopic repair of a perforated duodenal ulcer. In this case, herniation occurred after removal of a drain inserted through the trocar site intraoperatively and was treated with emergent open appendicectomy. A number of patient and technical factors may be associated with an increased risk of trocar-site herniation including increasing age, elevated body mass index, increasing trocar size, longer procedure duration and absence of fascial closure. These factors must be borne in mind when planning trocar placement and number to reduce the risk of herniation.
机译:套管耳网疝是腹腔镜手术的罕见并发症,可以作为早期发作,晚期或特殊类型进行分类。特殊类型的疝气通常发生在术后早期的时间内,并通过腹壁的所有层导致腹腔内含量的展示,没有覆盖的疝囊。我们在腹腔镜修复穿孔十二指肠溃疡的腹腔镜修复后,通过右侧髂骨骨的5毫米套管部位提出了一种特殊类型的附录疝。在这种情况下,在去除通过术中插入的排水管后发生突出,并用外部开放的阑尾切除术治疗。许多患者和技术因素可能与套轨道部位疝的风险增加有关,包括增加年龄,升高的体重指数,增加的套管针尺寸,更长的程序持续时间和肌肉封闭的缺失。在规划套管针的安排和数量以降低遍布趋势的风险时,必须考虑这些因素。

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