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A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia

INTRODUCTION AND IMPORTANCE: The incidence of Richter's hernias has risen in part due to the increment use of laparoscopic surgery. The standard technique to manage a strangulated Richter's hernia is bowel resection with anastomosis. Alternatively, invagination of the necrotic area in the...

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Autores principales: Carmona, Marleny, Singares, Eduardo Smith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9240795/
https://www.ncbi.nlm.nih.gov/pubmed/35753232
http://dx.doi.org/10.1016/j.ijscr.2022.107335
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author Carmona, Marleny
Singares, Eduardo Smith
author_facet Carmona, Marleny
Singares, Eduardo Smith
author_sort Carmona, Marleny
collection PubMed
description INTRODUCTION AND IMPORTANCE: The incidence of Richter's hernias has risen in part due to the increment use of laparoscopic surgery. The standard technique to manage a strangulated Richter's hernia is bowel resection with anastomosis. Alternatively, invagination of the necrotic area in the enterocele maintains a clean surgical field and allows for the use of a mesh when closing the abdominal wall. In a sterile surgical field, the use of a prosthetic reinforcement has shown advantages, including low rates of long-term complications and reduced rates of hernia recurrence. CASE PRESENTATION: A 35-year-old male presented with a strangulated Richter's hernia in a periumbilical abdominal wall defect. In the Operating Theatre, the necrotic segment was managed laparoscopically by plication with invagination allowing for abdominal wall reconstruction with a mesh. CLINICAL DISCUSSION AND CONCLUSION: We propose the laparoscopic repair of Richter's hernia with plication and invagination whenever feasible, therefore avoiding a bowel resection and maintaining a clean surgical field; which allows for use of prosthetic mesh.
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spelling pubmed-92407952022-06-30 A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia Carmona, Marleny Singares, Eduardo Smith Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: The incidence of Richter's hernias has risen in part due to the increment use of laparoscopic surgery. The standard technique to manage a strangulated Richter's hernia is bowel resection with anastomosis. Alternatively, invagination of the necrotic area in the enterocele maintains a clean surgical field and allows for the use of a mesh when closing the abdominal wall. In a sterile surgical field, the use of a prosthetic reinforcement has shown advantages, including low rates of long-term complications and reduced rates of hernia recurrence. CASE PRESENTATION: A 35-year-old male presented with a strangulated Richter's hernia in a periumbilical abdominal wall defect. In the Operating Theatre, the necrotic segment was managed laparoscopically by plication with invagination allowing for abdominal wall reconstruction with a mesh. CLINICAL DISCUSSION AND CONCLUSION: We propose the laparoscopic repair of Richter's hernia with plication and invagination whenever feasible, therefore avoiding a bowel resection and maintaining a clean surgical field; which allows for use of prosthetic mesh. Elsevier 2022-06-22 /pmc/articles/PMC9240795/ /pubmed/35753232 http://dx.doi.org/10.1016/j.ijscr.2022.107335 Text en © 2022 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Carmona, Marleny
Singares, Eduardo Smith
A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title_full A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title_fullStr A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title_full_unstemmed A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title_short A novel laparoscopic non-resective technique for the management of strangulated Richter's hernia
title_sort novel laparoscopic non-resective technique for the management of strangulated richter's hernia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9240795/
https://www.ncbi.nlm.nih.gov/pubmed/35753232
http://dx.doi.org/10.1016/j.ijscr.2022.107335
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