A Case of a Broad Ligament Hernia-associated with Small Bowel Strangulation Successfully Treated with a Single Port Laparoscopic Surgery

Abstract

A 38-year-old female presented at our hospital with lower abdominal pain. Computed tomography showed small bowel strangulation caused by the defect of an internal hernia through the right side of the broad ligament of the uterus. We performed an emergency single port laparoscopic surgery. Findings were a 2×3 cm defect of the broad ligament and ileum had herniated into the defect. We released the herniated ileum and sutured the defect of the broad ligament. After the laparoscopic procedure we pulled out the ileum from the umbilical section to observe the herniated ileum and confirmed there were no ischemic signs. Evaluation of the presence of ischemia in a herniated intestine is important in surgery for bowel strangulation. In laparoscopic surgery it is however difficult because it can only be performed by the surgeon under video-assisted laparoscopy. In single port laparoscopic surgery the surgeon can directly observe the herniated ileum from the umbilicus section. Therefore, single port laparoscopic surgery is a good adaptation for a strangulated ileus.