Prophylactic Mesh vs Suture in the Closure of the Umbilical Trocar Site after Laparoscopic Cholecystectomy in High-Risk Patients for Incisional Hernia. A Randomized Clinical Trial

European Hernia Society guidelines on the closure of abdominal wall incisions

“…Armananzas et al [113] reported in a recently published RCT a benefit for prophylactic intraperitoneal placement of a ventral patch at the umbilical site in high-risk patients to reduce the incidence of trocar-site hernia from 18.5 to 4.4 % (OR 10.1: CI 2.15-47.6; p \ 0.001). Larger sample-sized studies with a good riskbenefit assessment and longer follow-up are needed to confirm and support a stronger recommendation.…”

Ventral hernia: Patient selection, treatment, and management

“…In randomized controlled trials of prophylactic synthetic mesh placement to prevent hernia formation during contaminated cases such as cholecystectomy, stoma reversal, and bariatric surgery, synthetic mesh has been shown to decrease rates of hernia formation without dramatically increasing the rates of SSI (for prophylactic mesh versus suture for umbilical trochar site following laparoscopic cholecystectomy: hernia OR 10.1, 95% CI 2.2-47.6; SSI OR 2.0, 95% CI 1.7-2.5). [109][110][111][112] These studies include both intraperitioneal and preperitoneal mesh placement. However, in a randomized controlled trial of prophylactic biologic matrix placement to prevent hernia formation during contaminated cases like bariatric surgery, biologic matrix has not been shown to decrease rates of hernia formation (OR 0.9, 95% CI 0.5-1.5).…”

Transumbilical single-incision laparoscopic cholecystectomy: long-term review from a single center

“…This association is related to the weaker anatomic region of the midline of the abdomen combined with the larger diameter of the incision at that level, since frequently fascia dilations were needed to extract the specimen. So, prosthetic closure of the umbilical trocar site after laparoscopic surgery could become the standard method for preventing umbilical hernia in high-risk patients [60]. As reported, a larger transumbilical incision was more likely to increase the incidence of incisional hernias [16,[61][62][63].…”