Successful management of early postoperative small bowel obstruction caused by peritoneal dehiscence after TAPP repair using an omental patch and anti-adhesion barrier: a case report.

Laparoscopic transabdominal preperitoneal (TAPP) repair has become a standard approach for inguinal hernia repair; however, rare but serious complications, such as small bowel obstruction (SBO) caused by peritoneal dehiscence, can occur. We report the case of an 82-year-old man who developed early postoperative SBO due to peritoneal dehiscence after TAPP. Although conservative management was initially attempted, it failed to resolve the symptoms. Laparoscopic reoperation on postoperative day 21 revealed small bowel loops adherent to the mesh through a peritoneal defect. As the peritoneum was retracted and fragile, primary closure was not feasible. The defect was successfully repaired using a pedicled omental flap reinforced with an anti-adhesion barrier. The postoperative course was uneventful. Four years later, laparoscopic observation confirmed complete peritoneal regeneration without adhesions. When primary peritoneal reclosure is not feasible, reconstruction using a pedicled omental patch and an anti-adhesion barrier is a simple, safe, and durable method.