A spiral tack as a lead point for volvulus.

Laura Withers, Ann Rogers

Research output: Contribution to journalReview article

15 Scopus citations

Abstract

BACKGROUND AND OBJECTIVES: We present a case of small bowel volvulus around an endotack applied during total extraperitoneal laparoscopic hernia repair (TEP). This complication prompts reconsideration of the role of tacks during extraperitoneal laparoscopic hernia repairs. METHODS: We undertook a chart review and provide a case presentation with review of the literature. RESULT: A 66-year-old male with bilateral inguinal hernias underwent elective, bilateral, total extraperitoneal laparoscopic hernia repair. During dissection, a small peritoneal tear occurred. The tear was closed with a spiral tack. On postoperative day 22, the patient developed an acute abdomen. Exploratory laparotomy revealed a volvulus rotated around an adhesion to the spiral tack.DISCUSSION: Volvulus can cause vascular compromise leading to bowel ischemia and necrosis. A tack resulting in adhesion and volvulus is an unusual, but serious, complication. Repair of a peritoneal tear during preperitoneal hernia repair is advocated to improve visualization obstructed by a pneumoperitonuem and decrease adhesions to the abdominal wall. CONCLUSION: The use of blunt Endoloops or crimps may prove safer than tacks for repairing the peritoneum and placement in proximity to delicate or thin tissues. Additionally, careful placement of foreign bodies to ensure their stability and to minimize protrusion may decrease the risk of erosion of the hardware.

Original languageEnglish (US)
Pages (from-to)247-249
Number of pages3
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume10
Issue number2
StatePublished - Apr 2006

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Fingerprint Dive into the research topics of 'A spiral tack as a lead point for volvulus.'. Together they form a unique fingerprint.

  • Cite this