Systematic review of trocar-site hernia

Swank, Hilko A; Mulder, Irene M.; Chapelle, Claire F. la; Reitsma, Johannes B.; Lange, Johan F.; Bemelman, Willem A.

doi:10.1002/bjs.7836

Cited by 182 publications

(137 citation statements)

References 39 publications

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“…The first search for systematic reviews resulted in five records [33,40,41,46,49] and 25 additional records were screened by full text . Several studies comment on the incidence of trocar-site hernia for various trocar sizes.…”

Section: Trocar Size and Trocar Typementioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

488

406

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Section: Trocar Size and Trocar Typementioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

488

406

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“…Regarding umbilical port site SSI, there have been a number of reports and a systematic review indicating that SSI occurs at rates of 1.06-25.9% (6)(7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Transumbilical Wound Complications in Laparoscopic Gastric and Colorectal Surgery

Tomioka

Murakami

Fujimori

et al. 2018

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Laparoscopic surgery has become a standard gastrointestinal procedure that is currently the first choice. Despite this, there are some ongoing debates, some of which concern the surgical incision. Although adding an incision in the umbilicus has been avoided for fear of increased rates of surgical site infection (SSI) and postoperative adhesion, it was not associated with complications (1). There are a number of advantages, including esthetic ones; therefore, we have performed transumbilical incisions for organ removal since shortly after the introduction of laparoscopic surgery in the 1990s. For anatomical reasons, transumbilical incisions can easily be craniocaudally extended to adjust for the size of the excised organs, while maintaining the incision length at a minimum. Therefore, in our Department, after inserting 12-mm ports in the umbilicus, we extend the umbilical wound by approximately 3-5 cm in a craniocaudal direction to remove organs or anastomose them outside the body. In this study, we evaluated the complication rates and risk factors associated with transumbilical incisions and compared the incidence of its complications between colorectal and gastric resections in a cohort study of 643 consecutive laparoscopy performed at our Department in 4 years to examine the usefulness of this incision for laparoscopic abdominal surgery. Patients and MethodsStudy design. This was a cohort study of 643 consecutive patients who underwent laparoscopic procedures at the Department of Surgery, Division of Gastroenterological and General Surgery, Showa University, Japan, between January 2010 and December 2013. We excluded the following cases (n=447): those with followup at other hospitals from the early postoperative period within 3 months from surgery (n=221), those without organ removal from the transumbilical wound (n=115), those converted to laparotomy (n=65), and those undergoing multiple simultaneous procedures (n=46). Finally, 643 cases were included. The study protocol was approved by the Showa University Institutional Review Board (Approval number: 1917).Data collection and outcomes. Data were collected from our hospital database on patient sex, age, height, weight, body mass index (BMI), past history of diabetes mellitus (DM), type of surgery, surgical duration, amount of blood loss, maximum tumor diameter, intraoperative accident, SSI, umbilical wound port site hernia, and length of postoperative hospital stay. SSI was defined according to the criteria of the American College of Surgeons National Surgical Quality Improvement Program (2). Wound hernia was defined according to the definition by Tonouchi et al. (3). In order to evaluate early-and late-onset umbilical wound complications for laparoscopic procedures, we followed-up the patients every 3 months in the first postoperative year, and yearly thereafter for 3 years. We evaluated SSI as a short-term complication, and umbilical port site 943

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“…Medeiros et al proved that even though time of laparoscopic procedure was slightly longer by average 11 minutes than open surgery but it was related to considerably less postoperative pain, fewer unfavourable side effects and a shorter staying in hospital [22,23].…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed Adnexal Masses: Can be Managed by Laparoscopy Assisted Colpotomy?

Saleh¹

2015

Gynecol Obstet

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Laparoscopic procedures were moved ahead in management of gynecological problems. Improving the skill makes rate of complications of this procedure is low. Recently, it is believed the chosen practice for delighting adnexal Lesions. As Posterior colpotomy is applied only in laparoscopic hysterectomy. So, this study aimed to evaluate the safety and potential advantages of laparoscopy when assisted by colpotomy for organization of undiagnosed masses in adnexa through estimation of intraoperative events such as estimated blood loss, operative time and complications also postoperative pain and complications.

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Systematic review of trocar-site hernia

Abstract: TSH is an uncommon complication of laparoscopic surgery. The most important technical risk factors are the design and size of the trocars. The scientific evidence for recommendations to avoid TSH is sparse.

Cited by 182 publications

References 39 publications

European Hernia Society guidelines on the closure of abdominal wall incisions

European Hernia Society guidelines on the closure of abdominal wall incisions

Risk Factors for Transumbilical Wound Complications in Laparoscopic Gastric and Colorectal Surgery

Undiagnosed Adnexal Masses: Can be Managed by Laparoscopy Assisted Colpotomy?

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