Lateral sided trocar site hernia following laparoscopic hernia repair: results of a long-term follow-up

Sikar H. E., Cetin K., Eyvaz K., Altin O., Kaya S., Gokceimam M., ...More

HERNIA, vol.23, no.1, pp.101-106, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 23 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1007/s10029-018-1864-3
  • Journal Name: HERNIA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.101-106
  • Keywords: Incisional hernia, Trocar site hernia, Surgical mesh, Laparoscopy, CHOLECYSTECTOMY, CLOSURE
  • Çanakkale Onsekiz Mart University Affiliated: No

Abstract

PurposeTrocar site hernias (TSH) at the umbilical site following laparoscopic cholecystectomy forms the majority of the studies about TSH and there is a missing data in literature about lateral sided TSH. We aimed to evaluate the incidence and factors affecting lateral sided TSH occurrence following laparoscopic abdominal wall hernia repair (LAHR).MethodsPatients who underwent LAHR between March 2013 and 2015 were included in the study. Open approach with blunt dissection for optical trocar insertion and z-shaped suture for closure were used in 22 cases initially (Group 1). Sharp dissection and continuous suture for closure were used for the rest of the patients (Group 2).Results285 patients237 females (83.2%) and 48 males (16.8%)with a mean age of 50.1412.03 were included in the study. Most of the patients were overweight or obese and mean BMI was 29.25 +/- 5.04kg/m(2). BMI was significantly higher in patients with TSH (p:0.025) and TSH occurrence is significantly higher in Group 1 patients (p<0.001).Conclusions Trocar insertion and closure technique have a major role in lateral sided TSH occurrence. Trying to avoid blunt dissection during trocar insertion, closure of trocar site with continuous suture and enlargement of skin incision to provide good view decreases lateral sided TSH occurrence. In addition, increase at the level of BMI has increased the probability of TSH occurrence and further studies are needed to evaluate efficiency of prophylactic prosthetic closure for obese patients.