5 mm port site hernia causing small bowel obstruction

We present a case of acute postoperative small bowel obstruction following laparoscopic ovarian cystectomy. The patient returned to theatre for second look laparoscopy where a 5-mm port-site hernia containing small bowel was found at the site of a previous drain. The hernia was reduced and the defect closed with sutures. This should make surgeons rethink the assumption that herniae do not occur through 5-mm ports. The use of drains, methods of achieving port closure, ways of investigating postoperative ileus, and the treatment of port-site herniae are discussed.