Osvaldo Zumba, MD, Jordan Dozier, MD, George Mazpule, MD, Stephen G Pereira, MD, Adam Rosenstock. Hackensack University Medical Center
Robotic TAPP (Transabdominal Preperitoneal) has emerged as a viable option for the treatment of inguinal hernias. Compared to both the laparoscopic and open approach, the robotic repair offers less pain, similar recurrence rates, and less technical challenge. Though there are numerous possible complications that may occur as a result of the TAPP repair, small bowel obstruction (SBO) is one of the more frequent causes for reoperation. Two of the main causes for SBO in robotic repair are peritoneal flap failure and adhesions from exposure of the bowel to the frequently used V-Loc suture. Here, we present the case of a 51-year-old male who had recently undergone robotic bilateral TAPP inguinal hernia repairs, which presented with a SBO three days postoperatively. Interestingly, the cause of this obstruction was found to be an internal hernia from a defect greater than 3 centimeters in the peritoneal flap, and several centimeters away from the sutured peritoneum. This video shows the operation done robotically to resolve this pathology, which required the following: reduction of the small bowel from the extraperitoneal space off the previously placed mesh, enlargement of the hernia, and closure of a sizeable defect of the recently manipulated peritoneum. As a result of this procedure, the patient had quick resolution of his obstruction and did not require any further procedures to repair his hernias. Use of the robotic surgical platform for treating complications from robotic TAPP repairs is ideal, as it offers a minimally invasive approach that is less technically demanding.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95316
Program Number: V097
Presentation Session: Exhibit Hall Theater Video Session IV
Presentation Type: EHVideo