Abdominal wall paresis as a complication of laparoscopic surgery
Purpose: Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy. Methods: A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patient presenting with paresis of the internal oblique muscle due to a trocar lesion of the right iliohypogastric nerve after laparoscopic appendectomy. Results: Trocar placement in the upper lateral abdomen can damage the subcostal nerve (Th12), caudal intercostal nerves (Th7-11) and ventral rami of the thoracic nerves (Th7-12). Trocar placement in the lower abdomen can damage the ilioinguinal (L1 or L2) and iliohypogastric nerves (Th12-L1). Pareses of abdominal muscles due to trocar placement are rare due to overlap in innervation and relatively small sizes of trocar incisions. Conclusion: Knowledge of the anatomy of the abdominal wall is mandatory in order to avoid the injury of important structures during trocar placement.
|Keywords||Abdominal, Appendix, Complications, Hernia, Instruments-technical, Surgical-technical|
|Persistent URL||dx.doi.org/10.1007/s10029-009-0473-6, hdl.handle.net/1765/18472|
van Ramshorst, G.H., Kleinrensink, G.J., Hermans, J.J., Terkivatan, T., & Lange, J.F.. (2009). Abdominal wall paresis as a complication of laparoscopic surgery. Hernia: the journal of hernias and abdominal wall surgery, 13(5), 539–543. doi:10.1007/s10029-009-0473-6