• ANZ journal of surgery · Oct 2005

    Case Reports Comparative Study

    Unusual complications of laparoscopic totally extraperitoneal inguinal hernia repair.

    • Cheng Hean Lo, Dean Trotter, and Peter Grossberg.
    • Department of Surgery, Box Hill Hospital, Box Hill, Victoria, Australia. c_lo2@yahoo.com.au
    • ANZ J Surg. 2005 Oct 1;75(10):917-9.

    AbstractAlthough complications of laparoscopic totally extraperitoneal inguinal hernia repairs are well documented, the development of pneumothorax, pneumomediastinum and subcutaneous emphysema is rarely reported. The authors' experience with a 23-year-old man who developed intraoperative bilateral pneumothoraces and cervical subcutaneous emphysema during a laparoscopic totally extraperitoneal inguinal hernia repair prompted a MEDLINE literature review. Seven similar cases were found in which the patients developed pneumothorax, pneumomediastinum and/or subcutaneous emphysema following laparoscopic hernioplasty. An intercostal catheter was inserted in two out of the seven patients only. Numerous hypotheses were proposed for the development of these complications. Several authors felt that the duration of the procedure and preperitoneal insufflation pressures are related to the development of these complications. These potentially lethal complications must be diagnosed and managed promptly.

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