P-072 INCIDENCE OF TROCAR SITE HERNIA AFTER LAPAROSCOPIC BARIATRIC SURGERY, A LONG TERM FOLLOW UP

Abstract

Abstract Aim Given the increased use of laparoscopic surgery, the possible complications associated with it must be considered. Trocar site hernias (TSH) are one of them, being more frequent in obese patients. With this study we want to know the importance of the problem and evaluate our own results. Methods We made an observational, descriptive, longitudinal and retrospective study in patients undergoing laparoscopic bariatric surgery with 12mm bladeless trocars without fascial closure between January 2015 and July 2016. They were interrogated about symptoms and postoperative infection in the ports, and an abdominal wall ultrasound were performed by an expert radiologist in December 2022. Results 45 patients were included. The average age was 49.9 years-old (77.8% women) with a mean initial BMI of 45.5kg/m2 and actual BMI of 30.2 kg/m2. Among risk factors we found 31.1% of smokers, 46.7% of diabetes and 64.4% of respiratory pathology. The main surgery was gastric bypass (88.9%). 7 patients presented TSH (15.6%) and 6 patients presented symptomatology in any trocar site (13.3%), although only 2 (4.4%) showed hernia ecographically at the symptomatic port. We studied 189 ports and detected a 3.7% TSH in the control echography 6–7 years after surgery, all of them in the epigastric trocar. Conclusions The incidence of TSH after bariatric surgery with 12mm bladeless trocars is low considering patient´s characteristics. All the THS were in the midline port, which raises the possibility of systematic closure, change its position or contemplate this low incidence as acceptable considering its difficulty of closing.