OBJECTIVE

To identify the characteristics of irreducible and incarcerated trocar hernias (TH).

MATERIAL AND METHODS

An analysis was conducted on 6 female patients aged between 45 and 70 years with TH following laparoscopic surgeries. Four patients underwent surgery for cholecystitis, one for obesity, and one for a rectal tumor. According to the H. Tonouchi et al. (2004) classification, four patients had type II trocar hernias, and two had type III.

RESULTS

Three patients had TH above the navel: two combined with umbilical hernias, one with grade 2 rectus abdominis diastasis. Another had TH in the right iliac region, with a postoperative hernia in the left iliac region post-rectal tumor surgery. Herniotomy of the trocar and umbilical hernias was performed with the closure of defects through prosthetic plastic surgery using combined methods. Two patients experienced trocar hernias strangulation, one with Richter’s strangulation of the small intestine loop and the other with appendix strangulation, leading to secondary inflammation. Intestinal reduction and appendectomy were performed, and the defects in the abdominal wall were closed with local tissues.

CONCLUSION

Trocar hernias should be considered small-sized hernias, with a high risk of abdominal organs strangulation; hence, upon detection, an active rather than a wait-and-see approach should be adopted to address them. When the appendix shifts into a trocar hernia, morphological changes can be caused by the compression of its mesenteric vessels, gradually leading to the development of secondary inflammation in it and an obscured clinical picture.