J Gastric Cancer.  2012 Mar;12(1):49-52.

Late Onset Iatrogenic Diaphragmatic Hernia after Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer

• Suh Y
• Lee JH
• Jeon H
• Kim D
• Kim W

Abstract

Through the advent of surgical techniques and the improvement of laparoscopic tools including the ultrasonic activated scissor, laparoscopic gastrectomy has been increasingly used in far more cases of benign or malignant gastric lesions for the benefit of patients without compromising therapeutic outcomes. Even though possible complications provoked by the ultrasonic activated scissor can be prevented during the procedure with increasing advanced laparoscopic experience and supervision, unexpected late complications after the operations rarely occur. An extremely rare case of left incarcerated diaphragmatic hernia of the transverse colon developed in an 81-year-old female patient as a late complication, 8 months after laparoscopy-assisted total gastrectomy for gastric cancer, with laparoscopy successfully resumed and without the need to sacrifice any portion of the bowel.

Keyword

Ultrasonic activated scissor; Laparoscopic gastrectomy; Late complications; Diaphragmatic hernia

MeSH Terms

Aged, 80 and over
Colon, Transverse
Female
Gastrectomy
Hernia, Diaphragmatic
Humans
Laparoscopy
Organization and Administration
Stomach Neoplasms
Ultrasonics

Figure

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  Fig. 1 (A, B) Preoperative plain chest film showed air-fluid levels by the herniated bowels in the left pleural cavity.

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  Fig. 2 Coronal section of the chest computed tomogram showed herniated bowels definitely in the left pleural cavity preoperatively.

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  Fig. 3 Herniated transverse colon was retrieved through the diaphragmatic defect by laparoscopically.

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