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Small bowel obstruction after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report and review of the literature

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Abstract

Introduction

Transabdominal preperitoneal hernioplasty (TAPP) is a common procedure for groin hernia repair in adults. The peritoneal closure after mesh placement can be performed in various ways. In any case, thorough closure is recommended to avoid mesh exposure to the viscera with the risk of adhesions and bowel incarceration into peritoneal defects. Postoperative intestinal obstructions can mainly occur due to adhesions or bowel herniation through peritoneal defects into the dissected preperitoneal space. Incarcerations can also occur as a consequence of trocar site herniation.

Results and conclusion

Recently barbed self-anchoring knotless suturing devices are frequently used for peritoneal closure. The correct handling of such sutures is crucial to avoid potential complications. Despite of accurate management, bowel adherence and injuries or volvulus can occur.

Methods

We present an unusual case of a postoperative small bowel obstruction owing to strained adhesions and ingrowth between a small bowel segment and a polyglyconate unidirectional self-anchoring barbed suture device. Medline and PudMed databases were searched using the below-mentioned keywords and the literature on efficacy and safety of barbed sutures for peritoneal closure is reviewed as well as the usage of such devices in other fields of surgery.

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Conflict of interest

G. K. declares no conflict of interest.

F. M. declares no conflict of interest.

M. L. declares no conflict of interest.

R. B. declares no conflict of interest.

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Authors and Affiliations

  1. Academic Teaching Hospital of the Universities Graz and Innsbruck, Linz, Austria

    G. Köhler

  2. Department of Surgery, Paracelsus Medical University, Salzburg, Austria

    F. Mayer & M. Lechner

  3. Hernia-center Rottenburg am Neckar, Winghofer Medicum, Rottenburg am Neckar, Germany

    R. Bittner

Authors
  1. G. Köhler
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  2. F. Mayer
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  3. M. Lechner
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  4. R. Bittner
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Correspondence to G. Köhler.

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Köhler, G., Mayer, F., Lechner, M. et al. Small bowel obstruction after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report and review of the literature. Hernia 19, 389–394 (2015). https://doi.org/10.1007/s10029-014-1301-1

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  • DOI: https://doi.org/10.1007/s10029-014-1301-1

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