Port-site hernia after repeat staging procedures in a patient with a borderline ovarian tumor: a case report

Laparoscopic surgery has become the gold standard in gynecology owing to its minimal invasiveness and low complication rate. However, its widespread use makes awareness of rare but potentially serious risks, such as port-site hernia, critically important. This complication, reported in 0.34%–5.40% of cases, may develop even with flawless surgical technique and no apparent predisposing factors. We present a rare case involving a 47-year-old patient. After an initial laparoscopic procedure for an ovarian cyst, histological examination revealed a serous borderline ovarian tumor. The patient subsequently underwent a repeat laparoscopy with hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. No intraoperative complications occurred; ports were inserted in the standard manner, and the resected tissue was removed transvaginally in an endobag. Nevertheless, in the postoperative period, the patient developed dyspeptic symptoms refractory to conservative therapy. During follow-up, progressive partial high small-bowel obstruction was identified. On postoperative day 12, laparotomy revealed a loop of small intestine incarcerated in a port-site defect of the anterior abdominal wall. Hernioplasty was performed. Analysis of the case suggests that despite the absence of classical risk factors (obesity, diabetes), enlargement of the trocar port during extraction of a bulky specimen in the first operation was likely the predisposing event. This observation underscores that the risk of port-site hernia persists even when technique is optimal. Nonspecific symptoms such as dyspepsia may mask a life-threatening condition—intestinal obstruction. Careful fascial closure of trocar-site wounds, particularly in middle-aged and older patients, remains the key preventive measure of such complications.