Abstract
Purpose
Trocar site hernias (TSH) at the umbilical site following laparoscopic cholecystectomy forms the majority of the studies about TSH and there is a missing data in literature about lateral sided TSH. We aimed to evaluate the incidence and factors affecting lateral sided TSH occurrence following laparoscopic abdominal wall hernia repair (LAHR).
Methods
Patients who underwent LAHR between March 2013 and 2015 were included in the study. Open approach with blunt dissection for optical trocar insertion and z-shaped suture for closure were used in 22 cases initially (Group 1). Sharp dissection and continuous suture for closure were used for the rest of the patients (Group 2).
Results
285 patients—237 females (83.2%) and 48 males (16.8%)—with a mean age of 50.14 ± 12.03 were included in the study. Most of the patients were overweight or obese and mean BMI was 29.25 ± 5.04 kg/m2. BMI was significantly higher in patients with TSH (p:0.025) and TSH occurrence is significantly higher in Group 1 patients (p < 0.001).
Conclusions
Trocar insertion and closure technique have a major role in lateral sided TSH occurrence. Trying to avoid blunt dissection during trocar insertion, closure of trocar site with continuous suture and enlargement of skin incision to provide good view decreases lateral sided TSH occurrence. In addition, increase at the level of BMI has increased the probability of TSH occurrence and further studies are needed to evaluate efficiency of prophylactic prosthetic closure for obese patients.
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The study was approved by Dr. Lutfi Kirdar Kartal Research and Education Hospital Ethics Committee with the registration number of 5141275.
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Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”.
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Sikar, H.E., Çetin, K., Eyvaz, K. et al. Lateral sided trocar site hernia following laparoscopic hernia repair: results of a long-term follow-up. Hernia 23, 101–106 (2019). https://doi.org/10.1007/s10029-018-1864-3
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DOI: https://doi.org/10.1007/s10029-018-1864-3