Our Summary

This research paper discusses the rare instance of internal hernias in the small intestine following laparoscopic colorectal surgery - a minimally invasive procedure to treat conditions of the colon and rectum. In most cases, these hernias appear due to a defect in the mesentery, the tissue that attaches the intestines to the abdominal wall. However, no studies have yet explored when it would be appropriate to close these defects to prevent hernias from forming. This study presents a case where an internal hernia developed near a ligament in the upper part of the small intestine in a patient who had undergone laparoscopic sigmoidectomy, a procedure to remove a part of the colon, along with other techniques. The study emphasizes the importance of assessing the risk of hernias before surgery is completed. Also, closing the mesenteric defect should be considered to prevent hernia development in patients at risk.

FAQs

  1. What is an internal hernia and how common is it after laparoscopic colorectal surgery?
  2. What is the significance of closing mesenteric defects in preventing the development of an internal hernia?
  3. What are the potential risks of internal herniation in patients who undergo laparoscopic sigmoidectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sigmoidectomy is to be aware of the risk of internal herniation after the surgery. It is important for patients to discuss with their surgeon the possibility of closing mesenteric defects during the procedure to prevent the development of an internal hernia. Patients should also be vigilant for any symptoms such as abdominal pain, bloating, or vomiting, which could indicate a potential internal hernia and seek medical attention promptly if they experience any of these symptoms.

Suitable For

Patients who may be recommended sigmoidectomy include those with:

  1. Colorectal cancer
  2. Diverticulitis
  3. Inflammatory bowel disease
  4. Chronic constipation
  5. Benign colorectal polyps
  6. Severe hemorrhoids
  7. Colorectal obstruction

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine the most appropriate treatment plan for their specific condition.

Timeline

  • Before sigmoidectomy: The patient will undergo preoperative evaluations to determine the need for surgery. This may include imaging tests, blood work, and consultations with various specialists. The patient will also receive instructions on how to prepare for the surgery, such as fasting and medication adjustments.

  • Day of sigmoidectomy: The patient will arrive at the hospital and undergo the surgery under general anesthesia. The surgeon will remove the affected portion of the sigmoid colon and possibly nearby lymph nodes. The surgery may be done using a laparoscopic approach, which involves small incisions and a camera for visualization.

  • After sigmoidectomy: The patient will be monitored in the recovery room before being transferred to a hospital room. Pain management, wound care, and physical therapy may be provided to help with recovery. The patient will gradually resume eating and drinking and may be discharged from the hospital within a few days.

  • Follow-up appointments: The patient will have follow-up appointments with the surgeon to monitor healing and discuss any postoperative complications. It is important for the patient to follow all postoperative instructions and attend all scheduled appointments to ensure a successful recovery.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with sigmoidectomy surgery?
  3. How long is the recovery time after sigmoidectomy surgery?
  4. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  5. How will the surgery affect my bowel movements and digestion?
  6. Will I need any follow-up procedures or tests after the sigmoidectomy?
  7. What signs or symptoms should I watch for that may indicate a complication after the surgery?
  8. How likely am I to develop an internal hernia after the surgery, and what can be done to prevent it?
  9. What is the success rate of sigmoidectomy surgery for my condition?
  10. Are there any alternative treatment options to sigmoidectomy that I should consider?

Reference

Authors: Feng D, Kondo A, Asano E, Matsukawa H, Nishiura B, Ando Y, Suto H, Kishino T, Oshima M, Kumamoto K, Okano K. Journal: Asian J Endosc Surg. 2023 Jul;16(3):595-598. doi: 10.1111/ases.13195. Epub 2023 Apr 25. PMID: 37186421