Port site hernia in laparoscopic surgery: Way to prevent it
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Hellenic Journal of Surgery (2016) 88:6, 402-404
Port Site Hernia in Laparoscopic Surgery: Way to prevent it Najmus Saadat Jamadar, Deb Kumar Ray, Saswati Das
Abstract Background: Port-site hernia (PSH) is not a very rare complication following laparoscopic surgery. Incidence of PSH probably is a bit of understatement, as the common laparoscopic surgical procedures are not followed up on a regular basis in most parts of the world. This study aimed to review the present literature, current incidence and causes of PSH and to adopt a technically easier method to reduce the incidence of developing PSH following laparoscopic surgery. Methods: In a series of 200 patients for laparoscopic appendectomy and laparoscopic cholecystectomy we introduced
one 11 mm safety trocar just above or below the umbilicus at the paramedian site through the rectus abdominis muscle, avoiding the midline for the purpose of telescope insertion instead of making the port at umbilicus. The incidence of port- site hernia was calculated and the predisposing factors were considered. Results: None out of 200 cases developed port site hernia in our 18-month follow-up, so in our study the incidence of PSH was 0%. Conclusion: The incidence of PSH in a range of laparoscopic procedures varies. There is a rising incidence of PSH
following laparoscopic colorectal, and bariatric surgeries as larger size ports are used quite often in those cases. The incidence of PSH following laparoscopic appendectomy and laparoscopic cholecystectomy can be minimized taking the predisposing factors into consideration and by adopting a easier modification of conventional technique. Key words: Port–site hernia; laparoscopic cholecystectomy; laparoscopic appendectomy; paramedian port
Introduction Port-site hernia (PSH) is a not very rare complication following laparoscopic surgery. With the advent of minimal access surgery for common surgical problems like gallstones, appendicitis, hernia and advanced gastrointestinal surgeries like colectomies, gastrectomies etc., it has become less morbid for patients, but, as with any surgical procedure, laparoscopic surgery is also attached with some specific complications, like port-site hernia (PSH). Incidence of PSH probably is a bit of understatement, as the common laparoscopic surgical procedures are not followed up on a Najmus Saadat Jamadar MBBS, MS Residential Medical Officer Cum Clinical Tutor Deptartment of Surgery, Medical college Hospital, Kolkata, India Deb Kumar Ray MBBS, MS, FRCS Senior Consultant & Laparoscopic Surgeon, A.M.R.I Hospital, Saltlake, Kolkata, India Saswati Das MBBS, MD Senior Resident, Department of Dermatology, N.R.S.Medical college Hospital, Kolkata, India Corresponding author: Dr. Najmus Saadat Jamadar MBBS, MS Residential medical Officer cum clinical tutor, Deptartment of Surgery Medical college Hospital, 88, College Street, Kolkata-700073, India e-mail: [email protected] Received 31 July 2016; Accepted 20 Οct 2016 Hellenic Journal of Surgery 88
regular basis in most part of the world. So there i
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