An 82-year-old man with an incarcerated right inguinal hernia was seen at the hospital. After a successful reduction, he underwent an laparoscopic hernia repair. On the third postoperative day, a small bowel obstruction occurred. The small bowel obstruction was not improved on a conservative therapy, and an laparotomy was performed. Laparotomy revealed that the repaired peritoneum using the stapler was separated, and two loops of the small bowel were compressed by the greater omentum adherent to the exposed mesh. The adherent omentum was dissected, and the peritoneum was closely re-approximated. The postoperative course was uneventful. The patient was discharged from the hospital on the 13th postoperative day.
The laparoscopic hernia repair has been reported to have many advantages, and may become a standard operative procedure for inguinal hernia in the future. In the laparoscopic hernia repair using the transperitoneal approach, it is necessary to close the dissected peritoneum carefully to prevent a small bowel obstruction which has never been complicated by the conventional hernia repair operation.