POST LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR EARLY SUBACUTE INTESTINAL OBSTRUCTION DUE TO INTERNAL BOWEL HERNIATION.

A patient underwent Bilateral Laparoscopic Inguinal Hernia Surgery, started to have meals on postoperative day 1 and Discharged.
He had a severe bout of cough at home on day 5 and started having Abdominal distension.

He was admitted with a diagnosis of Subacute Small Bowel Obstruction. 
He was managed for 48 hours conservatively but symptoms persisted. 
He was again taken for Diagnostic Laparoscopy and internal herniation of Distal Small bowel into a defect in lower flap of left side repair was noticed. It was Successfully reduced and the defect repaired primarily.
Patient recovered quickly and was discharged on 2nd postoperative day.
This is a very rare complication after Bilateral Laparoscopic (TAPP) inguinal hernia surgery.

Thanks to God almighty, due to timely intervention, could be managed laparoscopically.

TAKE HOME MESSAGE- The EARLY Small bowel obstructions after a minimally invasive surgery rarely get successfully managed conservatively. It is always prudent to do Diagnostic Laparoscopy after a trial of 24-48 hours. This is contradictory to general rule followed in case of Early Small bowel Obstruction in open surgeries, which states that most of early small bowel obstructions can be successfully managed conservatively.