Laparoscopic repair of lateral sided trocar site hernias.

Abstract

Repair of trocar site hernia (TSH) has been mentioned in a limited number of studies. Trocar site hernias are mostly located in the umbilical region with a small size. Laparoscopic repair could be a choice due to the appearance of large defects and requirement of mesh repair for lateral sided TSH. We aimed to share our experience with laparoscopic repair of lateral sided trocar site hernia (LRTSH) with a long term follow up. Twenty-three patients who underwent LRTSH between March 2013 and July 2015 were included in our study. Four edges of the mesh were fixed with pre-tied 2/0 polypropylene suture for 9 patients initially (Group 1). Unexpected complication of chronic pain in 3 patients led us to revise our method and we avoided to position the mesh with transabdominal sutures for the rest of the patients (Group 2). Nineteen (82.6%) female and 4 (17.4%) male patients, with a mean age of 50.9 years underwent laparoscopic repair. Following the revision and avoiding transabdominal sutures to position the mesh, no complaint of chronic pain was observed, and the difference was statistically significant between the groups (p<0.05). Previous laparoscopic surgery indicates the lack of obstacle in laparoscopic repair of TSH, and LRTSH can be considered as first option in treatment. Shorter mean operative time in obese patients and lack of recurrence in our series support this view. Using transabdominal sutures should be avoided to prevent chronic pain in LRTSH.