Port site hernia in laparoscopic surgery: Way to prevent it

Abstract

Port-site hernia (PSH) is not a very rare complication following laparoscopic surgery. Incidence of PSH probably is a bit of understatement, as the common laparoscopic surgical procedures are not followed up on a regular basis in most parts of the world. This study aimed to review the present literature, current incidence and causes of PSH and to adopt a technically easier method to reduce the incidence of developing PSH following laparoscopic surgery. In a series of 200 patients for laparoscopic appendectomy and laparoscopic cholecystectomy we introduced one 11 mm safety trocar just above or below the umbilicus at the paramedian site through the rectus abdominis muscle, avoiding the midline for the purpose of telescope insertion instead of making the port at umbilicus. The incidence of port- site hernia was calculated and the predisposing factors were considered. None out of 200 cases developed port site hernia in our 18-month follow-up, so in our study the incidence of PSH was 0%. The incidence of PSH in a range of laparoscopic procedures varies. There is a rising incidence of PSH following laparoscopic colorectal, and bariatric surgeries as larger size ports are used quite often in those cases. The incidence of PSH following laparoscopic appendectomy and laparoscopic cholecystectomy can be minimized taking the predisposing factors into consideration and by adopting a easier modification of conventional technique.