An Easy Way to Close the Trocar Hole in Obese Patients

Chien-Hua Lin,Jing-Jim Ou,Hurng-Sheng Wu,Yueh-Tsung Lee

doi:10.4236/ss.2015.610066

Chien-Hua Lin, Jing-Jim Ou + Show 2 more

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https://doi.org/10.4236/ss.2015.610066

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Journal: Surgical science	Publication Date: Jan 1, 2015
Citations: 10	License type: CC BY 4.0

Affiliation: Chang Bing Show Chwan Memorial Hospital

Abstract

Background: Ten-millimeter ports are often used in laparoscopic surgery. It could be difficult to close the ports sites, especially in obese patients. We described a new method to close ten-millimeter port-site wounds, effective and easily to perform. Methods: Forty cases of laparoscopic bariatric surgery were performed from April 2010 to September 2011 at IRCAD Taiwan. Among them, 30 patients received trocar hole closed with SURGICEL&reg Original Hemostat and the other 10 patients received trocar hole closed with autologous fat. The results were recorded. Results: In group of SURGICEL&reg Original Hemostat, includes 21 female and 9 male, age range from 18 to 54 with average 39.5 years. Average BMI is 42.4 (range from 32.6 to 55). The operations include 27 cases of laparoscopic sleeve gastrectomy, 2 cases of laparoscopic gastric bypass, and 1 case of laparoscopic mini-bypass. Group of autologous fat includes 3 female and 7 male, age range from 20 to 49 with average 38.6 years. Average BMI is 39 (range from 32.8 to 64.5). The operations include 9 cases of laparoscopic sleeve gastrectomy, and 1 case of laparoscopic mini-bypass. No complications of trocar wound including infection, hematoma, and hernia were found for a mean follow-up of 6 months. Conclusions: For obese patients, closure of port sites can be difficult. We described a method of closing 10-mm port-sites wounds, which are easy, effective, and not required any special instruments.

Highlights

Port site hernia is an important yet under-recognized complication of laparoscopic surgery, which carries a highHow to cite this paper: Lin, C.-H., Wu, H.-S., Ou, J.-J. and Lee, Y.-T. (2015) An Easy Way to Close the Trocar Hole in Obese Patients
We will cut down the fat pad over cardia to identify the angle of His, and the fat pad was prepared for closure of trocar hole
Surgicel could be as a substitute to plug into the hole. The demographics of these patients were shown in Table 1. 30 patients received trocar hole closed with SURGICEL® Original Hemostat, includes 21 female and 9 male, age range from 18 to 54 with average 39.5 years

Summary

Introduction

Port site hernia is an important yet under-recognized complication of laparoscopic surgery, which carries a high. How to cite this paper: Lin, C.-H., Wu, H.-S., Ou, J.-J. and Lee, Y.-T. (2015) An Easy Way to Close the Trocar Hole in Obese Patients. Lin et al risk of strangulation due to the small size of the defect involved [1]. There are numerous ways of closing laparoscopic wound. It is difficult in obese patients [3]. We used surgicel plug to fill the trocar hole [4]. We modified to use autologous fat as a substitute. This idea comes from autologous fat transplantation for breast augmentation.

Patients

Surgical Technique

Results

Discussion

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Method