2025 Volume 45 Issue 1 Pages 18-21
A 71-year-old man underwent transabdominal preperitoneal repair (TAPP) for right inguinal hernia. On postoperative day 1, he vomited after a meal. Abdominal CT showed paralytic ileus without obvious obstruction. Conservative treatment with an ileus tube failed to afford relief, and on postoperative day 14, an ileus tube-assisted small bowel series showed small bowel obstruction and caliber change near the site of the peritoneal closure in the right inguinal region. Therefore, we performed emergency laparoscopic surgery for suspected small bowel obstruction. The small intestine was found to have herniated through the peritoneal defect and was partially adherent to the mesh. We repositioned the small intestine and resutured the peritoneal defect. We did not think the mesh needed to be removed, because there were no ischemic changes in the incarcerated intestine. Intestinal obstruction related to the peritoneal defect in the suture line is a rare complication after TAPP. Precise peritoneal closure at surgery is necessary, and if the intestinal obstruction occurs in the early operative period after TAPP, early diagnosis and surgical intervention are important.
