A case of internal hernia after laparoscopic sacrocolpopexy for pelvic prolapse Nozomi KARAKUCHI 1,2 , Kazuhiro TOYOTA 2 , Masashi INOUE 2 , Ichiro OHMORI 2 , Masahiro IKEDA 2 , Tadateru TAKAHASHI 2 1Department of Surgery, JA Yoshida General Hospital 2Department of Surgery, National Hospital Organization Higashihiroshima Medical Center Keyword: 腹腔鏡下仙骨腟固定術 , 骨盤臓器脱 , 内ヘルニア pp.242-247
Published Date 2021/5/15
DOI https://doi.org/10.11477/mf.4426200907
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 Laparoscopic sacrocolpopexy (LSC) is asurgical procedure that has recently gained prominence for the treatment of pelvic organ prolapse. We present the case of a 70-year-old woman who developed bowel obstruction three months after having undergone LSC for bladder prolapse. The patient was diagnosed with an internal hernia in the pelvis, and emergency surgery was performed. A peritoneal depression was detected on the left side of the Douglas pouch in the pelvic floor, with incarceration of the small intestine. The incarceration was manually released, and the peritoneal cavity was closed. Subsequently, the patient has had no recurrence of pelvic organ prolapse or bowel obstruction. In the present case, we presume that the hernia had developed due to LSC procedure when the mesh lifted the vagina and the sacral uterine ligament; the small intestine consequently penetrated into the small pelvic cavity, which had become a dead space. Intestinal obstruction due to internal hernia has never been reported as a postoperative complication of LSC in the past; however it is one of the possible anatomical complications.

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