Laparoscopic port closure with a simple, inexpensive, effective and easy procedure to prevent port-site hernia

Abstract

BackgroundIn this modern era of surgery, laparoscopy is more popular than before and widely practised. Although the surgeons focus more on the laparoscopic technique of specimen extraction, less attention is given for port-site sheath and peritoneum closure, resulting in port-site hernia (PSH). Various methods and use of number of instruments have been described for closure of port-site defects. We are reporting a simple, inexpensive, but effective, technique for closure of port-site sheath as well as peritoneum to prevent PSH. Materials and methodsWe have used a looped spinal needle and another thread introducing spinal needle for closure of port-site sheath along with peritoneum under camera vision in 84 patients and compared with conventional open blind port closure in another 70 patients. ResultsThis procedure was used to close port-site defects in 84 patients (66 female and 18 male) after laparoscopic procedures during April 2016 to August 2018. Neither PSH nor other post operative complications was reported over a mean follow-up of 18 months with our described port-site closure method using spinal needles. But, we recorded 2 cases (2.85%) of PSH and one case (1.43%) of omental incorporation, resulting in persistent postoperative pain in the abdomen in the group of patients in whom conventional blind fascial closure was performed. ConclusionOur described procedure using spinal needles is an easy, safe and inexpensive port-site defect closure method to prevent PSH.