Inguinal hernia following the use of fluid anti-adhesive agents in laparoscopic surgery: a literature review and case report

Abstract

Introduction and importance: Inguinal hernia is a rare complication in females occurring due to the use of common anti-adhesion agents, such as ADEPT. Some complications have been reported to date; however, there are no reported cases of ADEPT-induced inguinal hernia. Case presentation: A 39-year-old woman underwent laparoscopic ovarian cystectomy for a right ovarian endometrioma, using ADEPT as an anti-adhesion agent. Subsequently, she developed an inguinal hernia diagnosed using pelvic computed tomography. The inguinal mass gradually decreased in size and disappeared four months after, without intervention. Clinical discussion: While rare complications have been reported, no cases of inguinal hernias induced by anti-adhesion agents have been reported to date. To minimize the risk of this complication, avoiding excessive intra-abdominal pressure to prevent possible peritoneal fluid migration through small orifices into low-pressure areas is advised. Additionally, applying external pressure over the superficial/deep inguinal rings until CO2 is completely removed from the abdominal cavity might be helpful. Conclusion: Inguinal hernia is a rare anti-adhesion solution complication in females. Minimizing the risk involves avoiding excessive intra-abdominal pressure and applying external pressure over the superficial/deep inguinal rings.