Incarcerated omental hernia at a 5-mm trocar site after lapa
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A 38-year-old woman gravida 3 para 1, aborta 2 with body mass index of 21 kg/m 2 underwent laparoscopic fulguration of endometriosis. Three 5-mm bladeless trocars were used. Superficial endometriosis implants in the posterior cul-de-sac and left uterosacral ligament were fulgurated using bipolar electrosurgery without difficulty. Two days later, the patient experienced a “pop-like” sensation in the umbilicus after coughing. Abdominal examination revealed a 4?×?2?×?1-cm pink-tan structure protruding through the umbilicus.

The patient underwent laparoscopy emergently; Veress technique was utilized to enter the left upper quadrant of the abdomen. An incarcerated omental hernia was noted through the umbilicus. The incarcerated portion of the hernia was considered contaminated given its exposure to the outside of the abdomen. Thus, the trailing, intra-abdominal end of the omentum was divided using a 5-mm LigaSure TM device. The fascial defect at the umbilicus was closed with 4 stitches using 0 Vicryl TM suture and the Endo Close TM device. Histopathology of the excised omental specimen revealed focal acute inflammation and hemorrhage.

Source: https://www.jmig.org/article/S1553-4650(20)30332-0/fulltext?rss=yes
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