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Low risk of trocar site hernia repair 12 years after primary laparoscopic surgery

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Abstract

Background

The risk of trocar site hernia (TSH) may be 0–22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair.

Methods

All patients in Denmark who underwent a laparoscopic procedure in 1997 were identified using the Danish National Patient Register and followed during a 12-year period. Hospital records for patients with an incisional or umbilical hernia repair were tracked and manually analyzed for possible relationship between reoperation and the initial laparoscopy.

Results

We included 7,626 patients. During follow-up, we identified 95 patients with TSH repair with a cumulative risk of 1.3% being lowest after minor gynecological procedures and appendectomy and highest after fundoplication, cholecystectomy, and oophorectomy. The TSH was mainly at the umbilicus site (n = 63, 66%), and 15 (16%) of the TSH repairs were performed as an emergency procedure.

Conclusions

The long-term risk of TSH repair is low, but the risk of an emergency operation for TSH is relatively high, which suggests that all patients with a TSH should be offered elective repair.

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References

  1. Mudge M, Hughes LE (1985) Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72:70–71

    Article  PubMed  CAS  Google Scholar 

  2. Bucknall TE, Cox PJ, Ellis H (1982) Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J 284:931–933

    Article  CAS  Google Scholar 

  3. Azurin DJ, Go LS, Arroyo LR, Kirkland ML (1995) Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg 61:718–720

    PubMed  CAS  Google Scholar 

  4. Bowrey DJ, Blom D, Crookes PF, Bremner CG, Johansson JL, Lord RV, Hagen JA, DeMeester SR, DeMeester TR, Peters JH (2001) Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication. Surg Endosc 15:663–666

    Article  PubMed  CAS  Google Scholar 

  5. Chelala E, Thoma M, Tatete B, Lemye AC, Dessily M, Alle JL (2007) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernia repair: mid-term analysis of 400 cases. Surg Endosc 21:391–395

    Article  PubMed  CAS  Google Scholar 

  6. Uslu HY, Erkek AB, Cakmak A, Kepenekci I, Sozener U, Kocaay FA, Turkcapar AG, Kuterdem E (2007) Trocar site hernia after laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A 17:600–603

    Article  PubMed  Google Scholar 

  7. Johnson WH, Fecher AM, McMahon RL, Grant JP, Pryor AD (2006) VersaStep trocar hernia rate in unclosed fascial defects in bariatric patients. Surg Endosc 20:1584–1586

    Article  PubMed  CAS  Google Scholar 

  8. Leibl BJ, Schmedt CG, Schwarz J, Kraft K, Bittner R (1999) Laparoscopic surgery complications associated with trocar tip design: review of literature and own results. J Laparoendosc Adv Surg Tech A 9:135–140

    Article  PubMed  CAS  Google Scholar 

  9. Smith AI, Royston CM, Sedman PC (1999) Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc 13:804–806

    Article  PubMed  CAS  Google Scholar 

  10. Boldo E, Perez de Lucia G, Aracil JP, Martin F, Escrig J, Martinez D, Miralles JM, Armelles A (2007) Trocar site hernia after laparoscopic ventral hernia repair. Surg Endosc 21:798–800

    Article  PubMed  CAS  Google Scholar 

  11. Helgstrand F, Rosenberg J, Bay-Nielsen M, Friis-Andersen H, Wara P, Jorgensen LN, Kehlet H, Bisgaard T (2010) Establishment and initial experiences from the Danish Ventral Hernia Database. Hernia 14:131–135

    Article  PubMed  CAS  Google Scholar 

  12. Schulze S, Iversen MG, Bendixen A, Larsen TS, Kehlet H (2008) Laparoscopic colonic surgery in Denmark 2004–2007. Colorectal Dis 10:869–872

    PubMed  CAS  Google Scholar 

  13. Funch-Jensen P, Bendixen A, Iversen MG, Kehlet H (2008) Complications and frequency of redo antireflux surgery in Denmark: a nationwide study, 1997–2005. Surg Endosc 22:627–630

    Article  PubMed  Google Scholar 

  14. Moller C, Kehlet H, Utzon J, Ottesen B (2002) Hysterectomy in Denmark. An analysis of postoperative hospitalisation, morbidity and readmission. Dan Med Bull 49:353–357

    PubMed  Google Scholar 

  15. Hussain A, Mahmood H, Singhal T, Balakrishnan S, Nicholls J, El-Hasani S (2009) Long-term study of port-site incisional hernia after laparoscopic procedures. JSLS 13:346–349

    PubMed  Google Scholar 

  16. Taylor GW, Jayne DG, Brown SR, Thorpe H, Brown JM, Dewberry SC, Parker MC, Guillou PJ (2010) Adhesions and incisional hernias following laparoscopic versus open surgery for colorectal cancer in the CLASICC trial. Br J Surg 97:70–78

    Article  PubMed  CAS  Google Scholar 

  17. Harboe KM, Anthonsen K, Bardram L (2009) Validation of data and indicators in the Danish Cholecystectomy Database. Int J Qual Health Care 21:160–168

    Article  PubMed  Google Scholar 

  18. Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M (2004) Trocar site hernia. Arch Surg 139:1248–1256

    Article  PubMed  Google Scholar 

  19. Helgstrand F, Rosenberg J, Bisgaard T (2010) Trocar site hernia after laparoscopic surgery: a qualitative systematic review. Hernia 15(2):113–121

    Article  PubMed  Google Scholar 

  20. Mahmoud Uslu HY, Ustuner EH, Sozener U, Ozis SE, Turkcapar AG (2007) Cannula site insertion technique prevents incisional hernia in laparoscopic fundoplication. Surg Laparosc Endosc Percutan Tech 17:267–270

    Article  PubMed  Google Scholar 

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Disclosures

Frederik Helgstrand, Jacob Rosenberg, Henrik Kehlet, and Thue Bisgaard have no conflicts of interest or financial ties to disclose.

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Helgstrand, F., Rosenberg, J., Kehlet, H. et al. Low risk of trocar site hernia repair 12 years after primary laparoscopic surgery. Surg Endosc 25, 3678–3682 (2011). https://doi.org/10.1007/s00464-011-1776-0

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  • DOI: https://doi.org/10.1007/s00464-011-1776-0

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