Abstract
Incisional hernia is a common sequel to open abdominal surgery, affecting 5–15% of patients. The introduction of laparoscopic surgery into clinical routine more than 20 years ago has dramatically changed the field of surgery. It is commonly held that the frequency of incisional hernia has been reduced since the introduction of minimal access surgery. The incidence of port site hernia ranges from 1% to 6%. The aim of this study is to identify most common causes of port site incisional hernia. This is a retrospective study of 2116 patients who underwent laparoscopic surgery between January 2006 and December 2010. The information obtained according to indication of surgery, onset of hernia, clinical risk factors for incisional hernia like age& sex, BMI, co-morbidity, and those related to surgical factors such as port site, port size, port site infection and abdominal access techniques. The data were retrieved for patients who developed port-site incisional hernia (PSIH). The incisional hernia rate for the entire series was 2.5%. Most port site hernias developed in the 10 mm port, in the umbilical and supra umbilical, midline and 0% for the off-midline. There was statistically significant difference in patient’s related risk factors regarding age, BMI and wound infection with development of port site hernias. Conclusion: In this series, the 10mm port in midline site is a significantly higher cause for incisional hernia than the off-midline and smallest port size. Open first access technique, obesity and port site infection also significantly increase the incidence of port site incisional hernia. Introductio
Highlights
Incisional hernia is a bulge or protrusion that occurs near or directly along prior abdominal surgical incision, it can occur at the site of any type of abdominal surgery from the breastbone down to the groin[1,2]
Aim of Study The aim of this study is to identify most common cause of port site incisional hernia regarding the port site, port size, first port access, port closure or not and port site infection as local causes and Body Mass Index (BMI), immunosuppressants and smoking as a general factors
The information was obtained regarding the indication of surgery, onset of hernia, clinical risk factors for incisional hernia like age,sex, BMI, smoking and co-morbidity, and those related to surgical factors such as port site, port size, port site infection and abdominal access techniques
Summary
Incisional hernia is a bulge or protrusion that occurs near or directly along prior abdominal surgical incision, it can occur at the site of any type of abdominal surgery from the breastbone down to the groin[1,2]. Incisional hernia is a common sequel to open abdominal surgery, affecting 5–15% of patients. The reported prevalence of this complication varies between studies, depending upon the type of incision employed, the patient group studied, and the duration of follow-up[3,4,5]. Laparoscopy is said to be the third patient-friendly revolution in medicine following the introduction of asepsis and anesthesia. It is commonly held that the frequency of incisional hernia has been reduced since the introduction of minimal access surgery. There have been a number of case reports describing herniation at
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