The Incidence of Trocar Site Hernia After Single-Port Laparoscopic Cholecystectomy-A Single Center Analysis and Literature Review.

Abstract

Single-port laparoscopic cholecystectomy (SLC) requires a larger initial umbilical incision than conventional multiport laparoscopic cholecystectomy (MLC). In this retrospective analysis study we compared the demographics, clinical data, and incidence of postoperative trocar site hernias (TSH) in patients undergoing SLC with those in patients undergoing MLC. A total of 161 patients were included in this study. Of these patients, 104 underwent MLC, 57 SLC. Patients in the MLC group were operated on using the four-trocar technique, patients in the SLC-port group using a fully reusable multi-trocar port system (X-Cone™). The earliest follow-up point was 12 months, the average follow-up period was 16.4 months (range 12-24 mos). The follow-up examinations for all patients consisted of a review of their medical history, a thorough physical examination, and an ultrasound examination of all existing trocar site scars. Patients in the SLC group had a lower mean American Society of Anesthesiologists score and a lower mean body mass index compared to patients in the MLC group. The average operating time was shorter for the patients in the SLC group, but the difference was not statistically significant. Ten (9.6%) patients in the MLC group and 3 (5.3%) in the SLC group developed a TSH (p = .55). At midterm follow-up the incidence of umbilical incisional hernias was not greater for SLC compared to MLC. The incidence of TSH after MLC was significantly higher than expected.