A study of laparoscopic port site complications – A descriptive study in a tertiary care hospital

Abstract

Background: Minimal access surgery commonly known as laparoscopic surgery among people is gold standard of care for many thoracic, abdominal, urological, and gynecological diseases with proven advantages and outcome over conventional surgeries. Due to recent technological advancement and enhanced surgical skills, more procedures are being done laparoscopically which were previously done conventionally. This rapid rise in magnitude of laparoscopic procedures has led to emergence of newer set of complications which are attributable to both access related and procedure specific. Aims and Objectives: The aims of this study were as follows: (1) To determine the incidence and type of port site complications following laparoscopic surgery. (2) To identify most common complication and possible causes and risk factors associated with these complications. Materials and Methods: It was a prospective observational study carried out in the General Surgery department of C.U. Shah medical college and Hospital after getting the Institutional Ethical Committee approval. Study included 100 patients admitted for planned as well as emergency laparoscopic surgery during February 2019 to December 2020. The patients were observed during early post-operative period and then followed up for 3 months for development of delayed port site complications. Results: It was observed that (63%) patients were male with majority patients in age group of 21–30 years (30%). Laparoscopic appendicectomy was the most common surgery performed (70%) and complications were most commonly associated with laparoscopic appendicectomy. Port site complications were observed in 33% patients (33/100). As an early port site complication, discharge, surgical site infection, port site bleeding, and port site emphysema were observed in 14, 8, 7, and 4 patients, respectively. These complications were more in patients with use of open or Hasson’s method of access, use of large port size (more than 5 mm size), and nonuse of specimen retrieval bag. Umbilical port was the most common site for overall complications. Conclusion: Overall, complications associated with laparoscopic port site are minimal and can be manageable with minimum morbidity.