Eventración de los orificios de los trocares en cirugía laparoscópica

Comajuncosas, Jordi; Vallverdú, Helena; Orbeal, Rolando; Parés, David

doi:10.1016/j.ciresp.2010.08.007

Cited by 26 publications

(17 citation statements)

References 46 publications

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“…All of the previous factors were found significant on univariate analysis. However, on multivariate analysis the list of significance was shortened to advancing age (>70), BMI > 30, duration of surgery, diabetes mellitus, incision enlargement, and wound infection as detailed in Table 3 7,10,11 .…”

Section: Pt Nomentioning

confidence: 99%

Characteristics of Trocar Site Hernia after Laparoscopic Cholecystectomy

Nofal

Ali

Hamdan

et al. 2020

Sci Rep

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Trocar site hernia (TSH) is an incisional hernia occurring at the trocar insertion sites after different types of laparoscopic surgeries. the aim of this study is to present characteristics of patient and surgery series with trocar site hernia after laparoscopic cholecystectomy. A 2930 consecutive patients underwent laparoscopic cholecystectomy in two major university-affiliated hospitals from April 2014 to March 2018 and the patient followed up for variable periods of time. Retrospective medical chart review to study trocar site hernia including patient, operation, instruments, and pathologic characteristics described. Six patients had trocar site hernia (incidence 0.20%), the hernias occurred mostly at the umbilical port site after using 10 mm trocar. Risk factors included mainly obesity, female gender and use of 10 mm trocars at midline sites. TSH is more described. It occurs mostly at the umbilical port site. Major risk factors include obesity, diabetes mellitus, lengthy procedure, extension of entry site, and wound infection. Closure of fascial defect is supposed to reduce the incidence despite weak evidence.Laparoscopic cholecystectomy (LC) was performed for the first time by Erich Mühe of Bo¨blingen, Germany on September 12, 1985 1 . It is now the standards surgical treatment for gallbladder stone disease (GBSD) and stood the test of time regarding reduced postoperative pain, decreased hospital stay, earlier return to work, and much more cosmetic scars. On the other hand, LC appeared progressively to have unprecedented complications such as complications related to the pneumoperitoneum and laparoscopic instruments in addition to the classical complications encountered in the open surgery such as bleeding, bile leak, and common bile duct injury.The trocar site hernia was reported for the first time in the late 1960s of the last century in a series of patients underwent laparoscopic gynecologic procedures 2 . The first case of TSH after LC was reported by Maio et al. in the USA in 1991in which they described the use of CT scan to diagnose the hernia 3 . Consequently, variable several studies were published addressing laparoscopic surgery complications including trocar site hernia. In this research, we present our observations regarding TSH after 2930 cases of LC.

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Section: Pt Nomentioning

confidence: 99%

Characteristics of Trocar Site Hernia after Laparoscopic Cholecystectomy

Nofal

Ali

Hamdan

et al. 2020

Sci Rep

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“…(1,10,12,15,16). duration of the procedure, presence of previous umbilical hernia, diabetes mellitus, or smoking, have been described as possible risk factors for TSIH (11,17) but according to our data only age and obesity can be con rmed as risk factors for TSIH.…”

Section: Discussionmentioning

confidence: 48%

Incidence and Risk Factors for Trocar-Site Incisional Hernia Detected by Clinical and Ultrasound Examination. Prospective Observational Study

Ciscar

Badía

Novell

et al. 2020

Preprint

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BACKGROUND: Trocar site incisional hernia (TSIH) is the most frequent complication associated with laparoscopic surgery. Few studies currently describe its incidence or risk factors. The aim of this report is to determine the real incidence of TSIH and to identify risk factors. METHODS: A cross-sectional prospective study was performed including consecutive patients who underwent a laparoscopic procedure during a four months period. All the patients were assessed both clinically (TSIHc) and by an ultrasonographic examination (TSIHu). The main variable studied was the incidence of TSIH. A multivariate analysis was performed to identify risk factors. RESULTS: 76 patients were included. 27.6% of patients were clinically diagnosed as having TSIH (TSIHc) but only 23.7% of those cases were radiologically confirmed (TSIHu). In the logistic regression analysis, age > 70 years (OR 3.462 CI 1.14 - 10.515, p = 0.028) and body mass index (BMI) ≥30 Kg / m2 (OR 3.313 CI 1.037-10.588, p = 0.043) were identified as risk factors for TSIH. The size of the trocar also showed statistically significant differences (p <0.001). Mean follow-up time was 34 months.CONCLUSIONS: TSIH is under-diagnosed due to the lack of related symptomatology and the inadequacy of the postoperative follow-up period. We detected discrepancies between the clinical and ultrasonographic examinations. TSIHu should be considered as the gold standard for the diagnosis of TSIH. Risk factors such as age, BMI and size of the trocar were confirmed. Patients should be followed-up for a minimum of 2 years.TRIAL REGISTRATION: The study has been registered in Clinicaltrials.gov, under registration number: NCT04410744.

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“…Any predisposing surgical and patient factors should be properly assessed, and closing all holes of any diameter is advised in obese patients, diabetic patients, or patients aged >60 years. 7 The port-closure techniques were classified by Shaher 1 into 3 groups: (1) techniques that use assistance from inside the abdomen (requiring 2 additional ports), (2) techniques that use extracorporeal assistance (requiring 1 additional port), and (3) techniques that can be performed with or without visualization (without additional ports). As a disadvantage, most of these techniques require special devices; some are time-consuming or require assistance from inside the abdomen (or both).…”

Section: Discussionmentioning

confidence: 99%