Port-Site Hernia Following Laparoscopic Cholecystectomy

Bunting, David

doi:10.4293/108680810x12924466007728

Cited by 109 publications

(101 citation statements)

References 35 publications

(83 reference statements)

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“…The closed environment of the umbilicus region increases the risk of secretion and infection around the incision in patient groups operated with multi-channel devices. Bunting reports that hernia development is most common in the umbilicus among the trocar insertion sites (88.9%) [5,[22][23][24]. Although actual rates are not known, Alptekin et al found the frequency of port site hernia development after the SILC technique to be about 3.2 times higher than the LC technique [5].…”

Section: Post-operative Complicationsmentioning

confidence: 99%

“…It is interesting that hernias only developed with the SILC method although both the SILC and MCAP methods use an umbilical entry site. The operation duration and incision size have been reported to be important factors in hernia development after laparoscopic procedures [22,23]. The longer trauma duration to the umbilicus in the single port method can affect the blood circulation in the area.…”

Section: Post-operative Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

The Comparison of Four-Port, Two-Port Without Suspension Suture and Single Port Laparoscopic Cholecystectomy Results

Sulu¹,

Allahverdi²,

Altun³

et al. 2016

Adv Clin Exp Med

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Section: Post-operative Complicationsmentioning

confidence: 99%

Section: Post-operative Complicationsmentioning

confidence: 99%

The Comparison of Four-Port, Two-Port Without Suspension Suture and Single Port Laparoscopic Cholecystectomy Results

Sulu¹,

Allahverdi²,

Altun³

et al. 2016

Adv Clin Exp Med

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“…Bunting suggests that umbilical port alone should be used for retrieval of gallbladder during cholecystectomy and the defect closed under direct vision, and all ports of >10 mm should be closed especially when cutting trocars are used [10]. Some suggest closing of port site 5 mm or larger [6], and in children, even less than 5 mm ports are also suggested to be closed routinely [7].…”

Section: Discussionmentioning

confidence: 99%

Case Series of Umbilical and Extra-umbilical Port Site Herniae

Jayaraman¹,

Rao²

2013

Indian J Surg

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Trocar site hernia or port site hernia (PSH) is a type of incisional hernia occurring at the trocar sites after laparoscopic surgeries. This is a rare but a potentially dangerous complication, as it can lead to considerable morbidity requiring surgical intervention. Various factors have been implicated for its development and various methods are also suggested for its prevention. We present here five cases of port site herniae.Keywords Laparoscopy . Trocar site . Port site . Hernia Case ReportsCase 1 A 43-year-old fit female presented with a swelling in the left lower abdomen for about 2 years. Pain developed about 10 days ago. On examination, there was a globular, mildly tender, and irreducible swelling of about 8 cm diameter in the left iliac fossa in the subcutaneous plane, with an 8-mm irregular trocar site scar on the skin (Fig. 1). The pain aggravated on coughing with no obvious cough impulse. Old records showed that she had undergone a diagnostic laparoscopy for infertility, and a 10-mm optical port was used at the umbilicus and a 5-mm port at the left iliac fossa, and only functional cysts of the ovaries were found, for which no treatment was suggested. There was no mention about the closure of trocar sites. A clinical diagnosis of irreducible laparoscopic 5 mm port site hernia was made, which was confirmed by abdominal ultrasound. She was operated through a transverse incision made over the swelling, and the hernia sac could easily be identified, after splitting the external oblique muscle fibers. The sac was opened and it contained viable omentum. The neck of the sac was about 7 mm in diameter, which was widened more to push back the omentum into the abdominal cavity. The abdominal cavity was explored by inserting a finger through the hernia defect and no adhesions were found. The sac was excised, the defect closed with 1-0 polypropropylene, and a polypropylene mesh was placed over the internal oblique muscle and fixed with 1-0 polypropylene sutures. The external oblique muscle was approximated with 2-0 polyglactin sutures over the mesh. The skin and subcutaneous tissues were approximated with staples. The patient had uneventful recovery and remains asymptomatic without recurrence about 5 years after surgery.Case 2 A 53-year-old female presented with a large swelling in the lower abdomen (Fig. 2), which developed after laparoscopic cholecystectomy done 3 years ago by us. She had noticed this swelling about a year after surgery, and abdominal pain was of recent onset. Though reducible, while standing, the swelling was very prominent and caused back pain. She was diagnosed to have a 10-mm port site hernia, which was confirmed by ultrasonography. Incidentally, she was a cured case of non-Hodgkin's lymphoma, non-cirrhotic portal fibrosis with portal hypertension, and anemia due to hypersplenism. Our records showed that the umbilical port site was closed with a 1-0 polypropylene. Open surgery was performed for this hernia and a large defect of about 15 cm was identified which was closed with 1-0 po...

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“…Furthermore, the cosmetic results of abdominal procedures could be further improved, inasmuch as it is a potentially scarless surgery. Minimizing incision-related complications could be even more important in the obese patient due to the negative effects of the thick abdominal wall causing greater postoperative pain and higher incisional hernia incidence rates [4]. The first report of a bariatric NOTES procedure in humans was published in 2008 by Ramos et al who presented their experience with trans-vaginal sleeve gastrectomy [5].…”

Section: Introductionmentioning

confidence: 99%

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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Much of the discussion pertaining to natural orifice transluminal endoscopic surgery (NOTES) focuses on technical issues, with little attention to women's perception and to their willingness to consent to this surgery, especially in the field of obesity. Aim of this study was to evaluate obese women's perception of NOTES and trans-vaginal access. Sixty two obese patients undergoing bariatric surgery were given a written description of NOTES with an anonymous questionnaire exploring their concerns and opinions regarding this technique. The risk of complications was the most important aspect with regard to surgical procedures for 87.1% of patients, while the aesthetic result counted only for 16.1%; none of the patients would accept an increased risk of surgical complications for a better aesthetic result, and 74.2% of them would prefer a standardized traditional surgical approach. Nulliparous women were more concerned about the potentially negative effects of NOTES on fertility than multiparous women and younger women were more worried about the effects on sexual function than older women. 83.9% of patients refusing NOTES stated that the main reason for their refusal was the lack of definitive data on the beneficial effects. Bariatric NOTES potentially offers obese women a scarless intervention, but only a few obese women expressed worries about the cosmetic/aesthetic effects of surgery, while most of them were worried about effects on future fertility and sexual life. Our study highlights a strong need for early reporting of outcome data to enlighten patients about this new approach to bariatric surgery.

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Port-Site Hernia Following Laparoscopic Cholecystectomy

Abstract: The incidence of port-site hernia is variable, but evidence suggests that awareness of risk factors and modification of technique can minimize risk.

Cited by 109 publications

References 35 publications

The Comparison of Four-Port, Two-Port Without Suspension Suture and Single Port Laparoscopic Cholecystectomy Results

The Comparison of Four-Port, Two-Port Without Suspension Suture and Single Port Laparoscopic Cholecystectomy Results

Case Series of Umbilical and Extra-umbilical Port Site Herniae

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

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