Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2637
Peer-review started: October 18, 2021
First decision: December 17, 2021
Revised: December 27, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 16, 2022
Processing time: 143 Days and 15.3 Hours
Drain-site hernia (DSH) has an extremely low morbidity and has rarely been reported. Small bowel obstruction is a frequent concurrent condition in most cases of DSH, which commonly occurs at the ≥ 10 mm drain-site. Here we report a rare case of DSH at the lateral 5 mm port site one month postoperatively without visceral incarceration. Simultaneously, a brief review of the literature was conducted focusing on the risk factors, diagnosis, and prevention strategies for DSH.
A 76-year-old male patient was admitted to our institution with intermittent abdominal pain and a local abdominal mass which occurred one month after laparoscopic radical resection of rectal cancer one year ago. A computed tomography scan showed an abdominal wall hernia at the 5 mm former drain-site in the left lower quadrant, and that the content consisted of the large omentum. An elective herniorrhaphy was performed by closing the fascial defect and reinforcing the abdominal wall with a synthetic mesh simultaneously. The postoperative period was uneventful. The patient was discharged seven days after the operation without surgery-related complications at the 1-mo follow-up visit.
Emphasis should be placed on DSH despite the decreased use of intra-abdominal drainage. It is recommended that placement of a surgical drainage tube at the ≥ 10 mm trocar site should be avoided. Moreover, it is advisable to have a comprehensive understanding of the risk factors for DSH and complete closure of the fascial defect at the drainage site for high-risk patients.
Core Tip: Drain-site hernia (DSH) is rarely reported at the 5 mm trocar site. In most cases, we prefer to place a large drainage tube at the ≥ 10 mm trocar site and directly remove it postoperatively without any measures to manage the fascial defects, and fail to continuously monitor co-existing disorders which may accelerate DSH formation. These situations may result in the development of DSH in some cases. Here, we report a rare case associated with a literature review to briefly summarize the risk factors, diagnosis, and prevention strategies for DSH.