Strangulated Incisional Hernia at Trocar Site

An incisional hernia at a trocar site after laparoscopy may arise from infection, premature suture disruption, or failure to adequately reapproximate fascial wound edges. The condition is accurately diagnosed postoperatively on physical examination, and a bulge at a previous port site should immediately raise suspicion. A case is reported in which an incisional hernia strangulated soon after an elective laparoscopic inguinal herniorrhaphy in which, the fascia of the 10-mm trocar site was not closed. This report underscores the importance of meticulous closure of all abdominal port sites > 5 mm. Furthermore, early diagnosis of an incarcerated hernia may avoid the morbidity of an extensive intestinal resection.