A Case of Postoperative Ileus Probably Caused by a Staple Slipped Down during a Laparoscopic Surgery.

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  • 腹腔鏡下手術時の落下ステイプルによる術後イレウスの１例

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Abstract

A 41-year-old woman was admitted to the hospital because of abrupt onset of lower abdominal pain and vomiting on September 28, 2000. There was a previous history of undergoing a laparoscopic excision of the left uterine support using automatic suture equipment for a left ovarian cyst. After a fasting and intravenous fluid under observation of clinical course, peritoneal signs appeared and an emergency operation was performed on September 30. Upon laparotomy, bloody ascites was present, the ileum aberrated and impacted into a crevice formed by adhesions of mesenteries, causing strangulated ileus. When the adhesions were freed, the ileus was released and a staple slipped from the automatic suture equipment was found at the anastomosed site. No adhesions other than the site were detected in the abdominal cavity. The strangulated intestine was viable and so no intestinal excision was conducted. The patient was discharged from the hospital on the 12th postoperative day and no recurrence of ileus has occurred thereafter. It is probable that a staple of an automatic suture equipment occasionally slips down, is left in elsewhere other than a planned portion, and can cause adhesion and resultant ileus. This case has suggested necessities of some device not to slip down an extra staple and careful recovery of slipped staple.

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