Here, we report our experience with a 5-mm
trocar site
hernia (TSH) near a stoma. This is the first report describing the relationship between TSH and extraperitoneal
colostomy. A 72-year-old man underwent laparoscopic
abdominoperineal resection with extraperitoneal sigmoid
colostomy and partial
hepatectomy for
rectal cancer accompanied by synchronous liver
metastasis (pT3N1aM1a Stage IVA Union for International
Cancer Control [UICC] 8th edition). The
surgical procedures were completely performed without morbidity. After 1 year, he presented to our hospital with sudden
nausea. Computed tomography (CT) revealed small bowel obstruction due to a 5-mm TSH, 1 cm from the stoma. The patient underwent laparoscopic
hernia repair. The incidence of a 5-mm TSH is low. However, an abdominal wall vulnerability caused by the extensive exfoliation of the retroperitoneum due to the construction of the
colostomy was observed, and the extraperitoneal
colostomy influenced the onset of the 5-mm TSH. When the port and
hernia sites are located in close proximity to each other, even a 5-mm
trocar site may increase the incidence of TSH.