Richter’s hernia occurring through a 5-mm laparoscopy sheath incision

• Published in: Gynecological surgery 2006-06, Vol.3 (2), p.132-133
• Main Authors: Bourdel, Nicolas, Roman, Horace, Lebouedec, Guillaume, Lenglet, Yann, Accoceberry, Marie, Canis, Michel
• Format: Article
• Language: English
• Subjects: Hernias; Wound healing
• ISSN: 1613-2076; 1613-2084
• DOI: 10.1007/s10397-006-0183-3

We report a case of postoperative Richter's hernia presenting through a 5-mm sheath incision. A 58-year-old woman having undergone laparoscopic hysterectomy 8 days before presented with severe left abdominal pain, nausea and light-headedness. The hypothesis of a sigmoid volvulus was suggested based on peroperative rectum and sigmoid release, the X-ray finding, and pain evolution. A secondary laparoscopic procedure allowed both diagnosis of a Richter's hernia through a 5-mm sheath incision and surgical repair of the hernia. The use of this sheath during the laparoscopic vagina suture caused extension of the wound. Large 5-mm sheath defect sufficient for a Richter's hernia can be created by multiple passes with small instruments and require surgical closure at the end of laparoscopy. Laparoscopy is useful in cases of postoperative complications, particularly when other complementary examinations are less informative.[PUBLICATION ABSTRACT]