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Influencing factors for port-site hernias after single-incision laparoscopy

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Abstract

Purpose

Single-incision laparoscopic surgery (SILS) has been demonstrated to be a feasible alternative to multiport laparoscopy, but concerns over port-site incisional hernias have not been well addressed. A retrospective study was performed to determine the rate of port-site hernias as well as influencing risk factors for developing this complication.

Methods

A review of all consecutive patients who underwent SILS over 4 years was conducted using electronic medical records in a multi-specialty integrated healthcare system. Statistical evaluation included descriptive analysis of demographics in addition to bivariate and multivariate analyses of potential risk factors, which were age, gender, BMI, procedure, existing insertion-site hernia, wound infection, tobacco use, steroid use, and diabetes.

Results

787 patients who underwent SILS without conversion to open were reviewed. There were 454 cholecystectomies, 189 appendectomies, 72 colectomies, 21 fundoplications, 15 transabdominal inguinal herniorrhaphies, and 36 other surgeries. Cases included 532 (67.6 %) women, and among all patients mean age was 44.65 (±19.05) years and mean BMI of 28.04 (±6). Of these, 50 (6.35 %) patients were documented as developing port-site incisional hernias by a health care provider or by incidental imaging. Of the risk factors analyzed, insertion-site hernia, age, and BMI were significant. Multivariate analysis indicated that both preexisting hernia and BMI were significant risk factors (p value = 0.00212; p value = 0.0307). Morbidly obese patients had the highest incidence of incisional hernias at 18.18 % (p value = 0.02).

Conclusions

When selecting patients for SILS, surgeons should consider the presence of an umbilical hernia, increased age and obesity as risk factors for developing a port-site hernia.

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Authors and Affiliations

  1. Scott & White Healthcare, 302 University Blvd, Round Rock, TX, 78665, USA

    F. P. Buckley III, H. E. Vassaur & C. J. Wheeless

  2. Scott & White Healthcare, 2401 S. 31st Street, Temple, TX, 76508, USA

    D. C. Jupiter

  3. Texas A&M Health Science Center College of Medicine, 2401 S. 31st Street, Temple, TX, 76508, USA

    J. H. Crosby & J. L. Vassaur

Authors
  1. F. P. Buckley III
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  2. H. E. Vassaur
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  3. D. C. Jupiter
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  4. J. H. Crosby
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  5. C. J. Wheeless
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  6. J. L. Vassaur
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Corresponding author

Correspondence to F. P. Buckley III.

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Conflict of interest

F.P. Buckley, MD has received a speaker honorarium in the past from Medronic. No other authors have any conflicts.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institution, received IRB approval, and with the 1964 Helsinki declaration and its later amendments.

Informed consent

As a retrospective study, formal consent was not obtained from the patients and was not required.

Funding

This study had no external funding.

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Buckley, F.P., Vassaur, H.E., Jupiter, D.C. et al. Influencing factors for port-site hernias after single-incision laparoscopy. Hernia 20, 729–733 (2016). https://doi.org/10.1007/s10029-016-1512-8

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  • DOI: https://doi.org/10.1007/s10029-016-1512-8

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