Perineal hernia as a rare complication after laparoscopic abdominoperineal resection: Report of a case

Tomotaka Akatsu, Shinji Murai, Satoshi Kamiya, Kenji Kojima, Yoshikazu Mizuhashi, Hirotoshi Hasegawa, Yuko Kitagawa

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

We report what seems to be the second documented case of perineal hernia after laparoscopic abdominoperineal resection (APR) and describe its successful repair with transperineal intraperitoneal mesh. An 89-year-old woman complained of a large, painful perineal swelling 4 months after APR for rectal cancer. Computed tomography (CT) showed small intestine protruding through the pelvic floor into the perineal area. However, opening of the hernia sac revealed no intra-abdominal adhesions. An oval, 8 × 12 cm Bard Composix Kugel Patch (Davol, Cranston, RI, USA) was inserted into the intraperitoneal space and secured over the defect in the pelvic floor; then firmly attached to the pelvic wall with 16 interrupted nonabsorbable sutures. There has been no sign of hernia recurrence in 10 months of follow-up. We speculate that because laparoscopic surgery is minimally invasive, fewer postoperative adhesions in the abdominal cavity can result in the small bowel sliding more readily into the perineal area. Based on our experience, perineal hernia after laparoscopic APR can be repaired easily and effectively with a Composix Kugel Patch.

Original languageEnglish
Pages (from-to)340-343
Number of pages4
JournalSurgery today
Volume39
Issue number4
DOIs
Publication statusPublished - 2009 Apr 1

Keywords

  • Abdominoperineal resection
  • Laparoscopy
  • Perineal hernia

ASJC Scopus subject areas

  • Surgery

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