Small bowel obstruction after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report and review of the literature

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• 作者：G. K枚hler ; F. Mayer ; M. Lechner ; R. Bittner
• 关键词：Barbed sutures ; Self anchoring sutures ; TAPP ; Small bowel obstruction/volvulus ; intestinal injury
• 刊名：Hernia
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：19
• 期：3
• 页码：389-394
• 全文大小：695 KB
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• 作者单位：G. K枚hler (1)
  F. Mayer (2)
  M. Lechner (2)
  R. Bittner (3)
  
  1. Academic Teaching Hospital of the Universities Graz and Innsbruck, Linz, Austria
  2. Department of Surgery, Paracelsus Medical University, Salzburg, Austria
  3. Hernia-center Rottenburg am Neckar, Winghofer Medicum, Rottenburg am Neckar, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Abdominal Surgery
  
• 出版者：Springer Paris
• ISSN：1248-9204

文摘

Introduction Transabdominal preperitoneal hernioplasty (TAPP) is a common procedure for groin hernia repair in adults. The peritoneal closure after mesh placement can be performed in various ways. In any case, thorough closure is recommended to avoid mesh exposure to the viscera with the risk of adhesions and bowel incarceration into peritoneal defects. Postoperative intestinal obstructions can mainly occur due to adhesions or bowel herniation through peritoneal defects into the dissected preperitoneal space. Incarcerations can also occur as a consequence of trocar site herniation. Results and conclusion Recently barbed self-anchoring knotless suturing devices are frequently used for peritoneal closure. The correct handling of such sutures is crucial to avoid potential complications. Despite of accurate management, bowel adherence and injuries or volvulus can occur. Methods We present an unusual case of a postoperative small bowel obstruction owing to strained adhesions and ingrowth between a small bowel segment and a polyglyconate unidirectional self-anchoring barbed suture device. Medline and PudMed databases were searched using the below-mentioned keywords and the literature on efficacy and safety of barbed sutures for peritoneal closure is reviewed as well as the usage of such devices in other fields of surgery.