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Gallbladder perforation by absorbable spiral tacker


Wirsching, A; Vonlanthen, R; Lehmann, K (2014). Gallbladder perforation by absorbable spiral tacker. Annals of the Royal College of Surgeons of England, 96(7):e22-e23.

Abstract

INTRODUCTION Mesh fixation with tacker systems is common in laparoscopic and open hernia repair. Complications due to absorbable tackers are rare and have not been described in the literature. However, we report a case of gallbladder erosion due to tacker dislocation. METHODS An open hernia repair was performed using an intraperitoneal onlay mesh for a recurrent parastomal hernia after two previous mesh repairs in a 67-year-old patient. RESULTS On postoperative day 2, the patient was reoperated because of a dislocated tacker that eroded and perforated the fundus region of the gallbladder. Putatively, tacker dislocation occurred owing to imbalanced traction forces. Initially, the mesh was fixed with absorbable tackers around the stoma on the right and transmuscular suture fixation was carried out on the left abdominal side. On revision surgery, tension forces to the right were therefore neutralised by additional transmuscular sutures on the right side. CONCLUSIONS Absorbable tackers in open hernia repair provide a safe and effective mesh fixation if tension forces are carefully avoided.

Abstract

INTRODUCTION Mesh fixation with tacker systems is common in laparoscopic and open hernia repair. Complications due to absorbable tackers are rare and have not been described in the literature. However, we report a case of gallbladder erosion due to tacker dislocation. METHODS An open hernia repair was performed using an intraperitoneal onlay mesh for a recurrent parastomal hernia after two previous mesh repairs in a 67-year-old patient. RESULTS On postoperative day 2, the patient was reoperated because of a dislocated tacker that eroded and perforated the fundus region of the gallbladder. Putatively, tacker dislocation occurred owing to imbalanced traction forces. Initially, the mesh was fixed with absorbable tackers around the stoma on the right and transmuscular suture fixation was carried out on the left abdominal side. On revision surgery, tension forces to the right were therefore neutralised by additional transmuscular sutures on the right side. CONCLUSIONS Absorbable tackers in open hernia repair provide a safe and effective mesh fixation if tension forces are carefully avoided.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Date:October 2014
Deposited On:23 Jan 2015 07:25
Last Modified:08 Dec 2017 10:03
Publisher:The Royal College of Surgeons of England
ISSN:0035-8843
Publisher DOI:https://doi.org/10.1308/003588414X13946184902280
PubMed ID:25245719

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