Trocar-Site Hernia After Diagnostic Laparoscopy

Trocar-site hernias occur due to various reasons and may cause life-threatening complications. Early diagnosis and treatment reduces morbidity and mortality rates. In this paper, we present a 43-year-old patient who presented to our emergency department with the complaints of nausea, vomiting, distention and inability to defecate occurred after a diagnostic laparoscopy for an abdominal stab wound. A computed tomography revealed a trocar-site hernia involving a small bowel segment. Trocar site was evaluated under general anesthesia and, after reduction of the bowel, the defect was closed primarily. On the first postoperative day, he was discharged uneventfully. Immediate mechanical bowel obstruction after laparoscopic surgery should be kept in mind to deal with these complications

Trocar-Site Hernia After Diagnostic Laparoscopy

Trocar-site hernias occur due to various reasons and may cause life-threatening complications. Early diagnosis and treatment reduces morbidity and mortality rates. In this paper, we present a 43-year-old patient who presented to our emergency department with the complaints of nausea, vomiting, distention and inability to defecate occurred after a diagnostic laparoscopy for an abdominal stab wound. A computed tomography revealed a trocar-site hernia involving a small bowel segment. Trocar site was evaluated under general anesthesia and, after reduction of the bowel, the defect was closed primarily. On the first postoperative day, he was discharged uneventfully. Immediate mechanical bowel obstruction after laparoscopic surgery should be kept in mind to deal with these complications

Pneumoperitoneum with Subcutaneous Emphysema after Percutaneous Endoscopic Gastrostomy

Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients. Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening. In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet

Effectiveness of local anesthetic application methods in postoperative pain control in laparoscopic cholecystectomies; a randomised controlled trial

Background: Laparoscopic cholecystectomy is a minimally invasive procedure that causes pain originating from parietal and visceral peritoneum. Many studies have been conducted to improve postoperative pain management and comfort of patients. Various methods such as local anesthetic injection (LAI) at trocar access points, intraperitoneal local anesthetic injection (IPLA), pneumoperitoneum pressure reduction, transversus abdominis plane block (TAPB), and reducing the number of trocars used during the operation were attempted to reduce postoperative pain. Methods: In this study, we compared LAI, TAPB and IPLA methods with the control group in which no local anesthetic was applied to reduce postoperative pain after laparoscopic cholecystectomy. We also demonstrated the effect of these methods on postoperative pain, need for additional analgesics, length of hospitalization, and patient satisfaction. Results: Overall, 160 patients aged 18-74 years who underwent laparoscopic cholecystectomy for cholelithiasis between October 2018 and August 2019 were included in the study and divided into four groups as follows: LAI group, TAPB group, IPLA group, and the control group without any intervention. Visual Analog Scale (VAS) values at 1, 2, 4, 6, 12, and 24 h in the control group were significantly higher than in the LAI, TAPB, and IPLA groups. Further, VAS values at 1, 2, 4, 6, 12, and 24 h in the IPLA group were significantly higher than in the LAI and TAPB groups. No significant difference was observed between the LAI and TAPB groups in terms of VAS values at 1, 2, 4, 6, and 24 h. VAS values at 12 h in the LAI group were significantly higher than in the TAPB group. Conclusions: Peroperative local anesthetic administration methods were more effective in preventing pain after laparoscopic cholecystectomy compared to the control group. In addition to reducing postoperative pain, these methods reduced the need for postoperative analgesics and increased patient satisfaction