Prospective Assessment of Trocar‐Specific Morbidity in Laparoscopy

Cristaudi, Alessandra; Matthey-Giè, Marie-Laure; Demartines, Nicolas; Christoforidis, Dimitri

doi:10.1007/s00268-014-2683-z

Cited by 22 publications

(19 citation statements)

References 30 publications

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“…The TSIH rate can change depending on the type of trocar and its location. TSIH have been described at any location, but those situated at the10mm trocar are the most frequent (9,10,(12)(13)(14). It seems that for 5 mm trocars facial closure should not be necessary, but for ≥ 10 mm trocars it would be mandatory.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…However, in the traditional OR for inguinal hernia, inguinal crease incision is considered to be scarcely visible because it is along the skin crease and usually is concealed under the cloths. On the other hand, umbilical incision for laparoscopy can cause umbilical deformities like protrusion, especially in reduced port surgery [ 15 ]. Moreover, in this study, the incidence of SSI was significantly higher in SILPEC than in OR group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases

et al. 2017

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BackgroudRecently, laparoscopic percutaneous extraperitoneal closure (LPEC) has gained increased popularity for pediatric inguinal hernia repair. To improve cosmesis, we developed single incision LPEC (SILPEC). The aim of this study was to assess the safety and feasibility of SILPEC compared with traditional open repair (OR).MethodsThis was a single-center retrospective cohort study of 2028 children who underwent inguinal hernia repair between April 2005 and August 2014. Nine hundred and ninety-five patients underwent OR and 1033 patients underwent SILPEC. Medical records were reviewed with respect to operative time, recurrence, incidence of contralateral metachronous inguinal hernia (CMIH), and complications. Patient satisfaction with cosmetic result was also investigated using questionnaires sent by mail. ResultsAll SILPEC procedures were completed without conversion. Operative time was longer in the SILPEC group than in the OR group for both unilateral and bilateral surgery regardless of sex (unilateral male: p = 0.0006, unilateral female: p < 0.0001, bilateral male: p < 0.0001, bilateral female: p < 0.0001). There was no statistically significant difference in recurrence rate (p = 0.43). The incidence of CMIH was significantly higher in the OR than in the SILPEC group (p < 0.0001). No postoperative testicular atrophy was found in either group. There was no statistically significant difference in ascending testis (p = 0.09), but the frequency of surgical site infection was higher in the SILPEC than in the OR group (p = 0.0013). According to the questionnaire, operative scar was more invisible in the SILPEC than in the OR group (p < 0.0001), but both procedures had equally high levels of satisfaction for cosmetic results (p = 0.58). ConclusionSILPEC proved to be a safe and feasible procedure compared with OR with an equally low recurrence rate, more effectiveness for preventing CMIH, and more invisible scar.

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“…They have further reported that bleeding was from the 12-mm port site in 14 patients and 5 mm port site in the remaining 3 patients. Complications such as bleeding and hernia can increase as port diameter increases (3,8).…”

Section: Discussionmentioning

confidence: 99%

The control of the port site bleedings with Foley catheter in obese patients

Gemici¹,

Okuş²,

Tanrıkulu³

2016

Electron J Gen Med

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The control of port site bleedings (PSB) is particularly difficult in obese patients. PSB can lead to morbidity via inhibiting the minimally invasive features of laparoscopic surgery such as the increase in the incision size. PSB can be controlled by Foley catheter. PSB has been observed in four patients with body mass index >35 and the bleeding cannot be prevented with different hemostasis techniques (for instance cauterization, etc.). Bleeding can be controlled upon placing the Foley catheter and then the balloon was inflated and putting it to the traction in the port site. Umbilical cord clamp was used instead of traditional methods for traction. In addition to the hemostatic effect of traction, the effect of compression of the umbilical clamp contributed to hemostasis. Catheter was removed after 24-36 hours. Bleeding did not occur again upon the usage of Foley catheter in these patients. Foley catheter traction is an easy and efficient hemostatic technique in patients with PSB.

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Prospective Assessment of Trocar‐Specific Morbidity in Laparoscopy

Abstract: Specific trocar morbidity is low and almost negligible for 5 mm trocars. The umbilicus appears to be an unfavorable TS.

Cited by 22 publications

References 30 publications

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

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

Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases

The control of the port site bleedings with Foley catheter in obese patients

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Prospective Assessment of Trocar‐Specific Morbidity in Laparoscopy

Abstract: Specific trocar morbidity is low and almost negligible for 5 mm trocars. The umbilicus appears to be an unfavorable TS.

Cited by 22 publications

References 30 publications

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

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

Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases

The control of the port site bleedings with Foley catheter in obese patients

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

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