[A Case of Port-Site Herniation from an Eight mm Port after Robot-Assisted Distal Gastrectomy].

Journal: Gan to kagaku ryoho. Cancer & chemotherapy
PMID:

Abstract

A 63-year-old-woman was diagnosed with gastric cancer cStage ⅠA after ESD, and then, underwent robot-assisted distal gastrectomy. She vomited on the postoperative day 2 and then was inserted nasogastric tube. The amount of drainage from the tube was increased on the postoperative day 5, therefore, abdominal computed tomography scan was performed, which showed herniation of small bowel at the 8 mm port site in the left upper abdomen. The emergent surgery was performed because of difficulty in manual reduction. Intraoperative findings showed that small intestine was incarcerated at the left 8 mm port-site. The intestine was released by incising the fascia of hernia orifice, then, the fascia was repaired. There was no recurrence of gastric cancer and port-site hernia for 34 months after surgery. In general, the fascia of over 10 mm port site is sutured and closed to avoid port-site hernia, however, it is unclear whether the fascia of 8 mm port-site should be closed after robotic surgery. Since we experienced this case, we have also performed fascia suture on the 8 mm port-site in all cases. And then, we could prevent occurrence of port-site hernia in the 8 mm port-site.

Authors

  • Atsushi Onodera
    Dept. of Surgery, Yokohama City University Hospital.
  • Kentaro Hara
  • Toru Aoyama
    Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center.
  • Mie Tanabe
  • Shun Shibuya
  • Yuta Nakayama
  • Shinnosuke Kawahara
  • Daishi Takahashi
  • Yosuke Atsumi
    Department of Surgery, Gastroenterological Center Yokohama City University Medical Center Yokohama Japan.
  • Keisuke Kazama
    Department of Surgery Yokohama City University Yokohama Japan.
  • Masakatsu Numata
    Department of Surgery, Gastroenterological Center Yokohama City University Medical Center Yokohama Japan.
  • Hiroshi Tamagawa
  • Norio Yukawa
  • Munetaka Masuda
  • Yasushi Rino
    Department of Surgery Yokohama City University Yokohama Japan.