TY - JOUR
TI - Pneumothorax as a rare complication during laparoscopic total
extra-peritoneal inguinal hernia repair: A case report and review of the
literature
AU - Koliakos, Nikolaos
AU - Papaconstantinou, Dimitrios
AU - Tzortzis,
AU - Andrianos-Serafeim
AU - Schizas, Dimitrios
AU - Bistarakis, Dimitrios and
AU - Bakopoulos, Anargyros
JO - Journal of Minimal Access Surgery
PY - 2021
VL - 17
TODO - 3
SP - 385-388
PB - Wolters Kluwer--Medknow Publications
SN - 0972-9941
TODO - 10.4103/jmas.JMAS_34_21
TODO - Inguinal hernia repair; pneumothorax; totally extra-peritoneal
TODO - Totally extra-peritoneal (TEP) and trans-abdominal pre-peritoneal repair
are the two most commonly performed types of laparoscopic hernia repair
procedures. Herein, we present a rare case of pneumothorax and
pneumomediastinum that ensued during a TEP inguinal hernia repair. A
73-year-old man presented for elective laparoscopic right-sided hernia
repair. After intubation, a 10-mm and two 5-mm trocars were placed in
the peri-umbilical and midline area, respectively. A balloon dissector
was inserted from the 10-mm trocar to develop the retro-rectus space and
carbon dioxide was insufflated up to a pressure of 14 mmHg. About 55 min
after insufflation, the patient presented subcutaneous emphysema, oxygen
saturation dropped from 100% to 96% and pCO2 increased to 55 mmHg. Due
to concerns for pulmonary embolism, he immediately underwent a chest
computed tomography, which revealed pneumothorax, pneumomediastinum and
subcutaneous emphysema extended throughout the neck, thorax and upper
abdomen. The patient was successfully treated conservatively with oral
analgesia and supplemental oxygen and was discharged on the 4th
post-operative day without any further complications.
ER -