A Case of Intestinal Obstruction Occurring Early After Transabdominal Preperitoneal Approach Surgery

Abstract

The patient was a 77-year-old man who presented with the chief complaint of swelling of the left inguinal region. There was no pain, and the bulge/swelling disappeared when the patient lay in the supine position. Abdominal CT showed inguinal herniation of the greater omentum and we made the diagnosis of left internal inguinal hernia. The patient was treated by TAPP. On postoperative day 2, he developed abdominal distension and nausea, and was diagnosed as having bowel obstruction. There was little improvement with the placement of an ileus tube, and although CT revealed no evidence of blood flow obstruction, we suspected bowel incarceration. On postoperative day 7, the patient underwent bowel obstruction release surgery. The cause of the bowel obstruction was found to be prolapse of the small bowel into the anterior bladder cavity from the peritoneal closure of the TAPP surgery. There was no evidence of blood flow obstruction to the intestine, and we judged that there was no need for intestinal resection, and closed the peritoneum after reduction of the prolapse. After reoperation, the patient had a good course and was discharged on the 15th postoperative day. The number of TAPP surgeries has been increasing in recent years, and there have been reports of complications that have not been reported with conventional methods. We encountered a case of intestinal obstruction occurring early after TAPP surgery, and report it with some discussion of the literature.