Assessing Effect of Fascial Non-Closure in 10 mm Trocar Sites on Incidence of Incisional Hernia

Abstract

Background: Trocar site, incisional hernia is one of the serious complications of laparoscopic surgery. As a result, many surgeons prefer to close the fascia, especially in those sites where a trocar of 10 mm in size or larger has been inserted. On the other hand, suturing the fascia may lead to damage of other tissues, such as the intestines; hence, some surgeons prefer not to close the fascia. Objectives: This study was performed to evaluate the outcome of using fascial non-closure in sites of 10 mm ports and the incidence of subsequent incisional hernia in patients undergoing laparoscopic cholecystectomy. Patients and Methods: The current study was a cohort scheduled for surgery in the General Surgery Ward at the Shariati Hospital of the Tehran University of Medical Sciences. Two hundred and twenty patients were selected in a convenient manner for a cholecystectomy. A 10 mm trocar was inserted in the umbilicus and the other ports were 5 mm. None of the trocar sites was closed. All of the patients were followed up to one year after the operation. Results: The mean age was 43.41 years and 91 patients (41.4%) were male. Five patients (2.3%) developed incisional hernia. The occurrence of hernia was not associated with; age, sex, BMI > 25, smoking or diabetes (P > 0.05). Conclusions: According to the results obtained in this study, it seems that in cases without closure of the fascia site of 10 mm trocars, the incidence of incisional hernia is considerable. Furthermore; age, gender, weight, smoking or diabetes, did not have any relationship with the occurrence of incisional hernia. More comparative studies are required to confirm these results.