5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair

Pereira, Nigel; Hutchinson, Anne P.; Irani, Mohamad; Chung, Eric; Lekovich, Jovana P.; Chung, Pak H.; Zarnegar, Rasa; Rosenwaks, Zev

doi:10.1016/j.jmig.2016.03.001

Cited by 29 publications

(24 citation statements)

References 39 publications

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“…The incidence of trocar hernia is 1–6% [ 5 ]. The incidence may be higher as not all surgeons report their complications, patients with a trocar hernia may be asymptomatic and cases may occur after the routine follow-up.…”

Section: Discussionmentioning

confidence: 99%

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Holzheimer¹,

Gaschütz

2020

Journal of Surgical Case Reports

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Reports on the ambulatory open repair of umbilical trocal hernias are missing. Patients with trocar, primary and recurrent umbilical hernia open suture and open suture–mesh repair with prospective follow-up were retrospectively evaluated. Patients received perioperative antibiotic prophylaxis, preemptive analgesia and modified anesthesia. In total, 171 patients with umbilical hernia (51 years, female 14%; male 86%) were treated with open suture (n = 29; 17%) and suture–mesh (n = 142; 83%) repair. In total, 10% of patients were treated for trocar hernia (late onset), 5% for recurrent hernia and 85% for a primary umbilical hernia. In total, 29% of trocar hernia repairs had minor complications associated with obesity (40%) and comorbidity (80%). Age, suture and suture–mesh repair were not associated with complications. According to guidelines for umbilical hernia repair open flat mesh may be useful in the treatment of trocar hernia.

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Section: Discussionmentioning

confidence: 99%

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Holzheimer¹,

Gaschütz

2020

Journal of Surgical Case Reports

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“…Kilic et al has suggested that longer robotic procedures increase the amount of force on the fascia, increasing the likelihood of a port site hernia 1. Other risk factors for port site hernias include diabetes, chronic cough, smoking, age greater than 60 and parity 12. Older, parous women are known to have fascial laxity which can place them at risk for larger fascial defects caused by laparoscopic and robotic surgery 12…”

Section: Discussionmentioning

confidence: 99%

Port site hernias following robotic colorectal surgery in people with obesity

Chang

Morin

Liu³

et al. 2018

BMJ Case Reports

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Port site hernias are a rare complication following robotic surgery that can result in disastrous outcomes. We describe incarcerated port site hernias in two patients with obesity. Both patients required laparoscopic reduction. Following laparoscopic reduction, one patient's postoperative course was complicated by pneumatosis intestinalis, requiring exploratory laparotomy and subsequent small bowel resection. It is standard practice to not close the fascia of port sites less than 12 mm in robotic surgery. However, this allows for the rare possibility of small bowel herniation through the port site. We suggest that our patients' history of obesity and metabolic dysfunction contributed to difficult port retention during the case, and longer operating times which caused an increased amount of torque at the port site. Additionally, compared with laparoscopic surgery, robotic surgery is associated with increased torque at port sites. The combination of these risk factors extended the fascial defect, ultimately leading to the incarceration of small bowel in the port site.

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“…Given the very low incidence of PSH at 5-mm trocar sites, literature on this topic is limited. Patient risk factors for the development of PSH include age greater than 60 years, male sex, obesity, parity, pre-existing fascial defect, surgical site infection and poor healing secondary to diabetes/steroid use/poor nutritional status [4]. With regards to parity, it is believed that parous women have abdominal wall and fascial laxity resulting in tissue that is vulnerable to developing fascial defects.…”

Section: Discussionmentioning

confidence: 99%

Five-Millimeter Port Site Hernia: A Rare Case

2018

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With advanced technology and improved training of surgeons, laparoscopic and other minimally invasive surgical techniques have become the standard of treatment for many general surgical and gynecological diseases. As with any surgical procedure, there are complications that can be directly attributed to the surgical technique. We present a case of an 84-year-old female who presented with symptoms of small bowel obstruction secondary to a 5-mm port site hernia (PSH) 1 week post-laparoscopic bilateral salpingo-oophorectomy for ovarian cysts.

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5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair

Cited by 29 publications

References 39 publications

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Port site hernias following robotic colorectal surgery in people with obesity

Five-Millimeter Port Site Hernia: A Rare Case

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