TROCAR SITE CLOSURE WITH OMENTAL PLUG INSERTION IN LAPAROSCOPIC BARIATRIC OPERATIONS: EFFICACY, SAFETY, AND OUTCOMES

Abstract

Introduction:Trocar site herniation (TSH) remains a significant complication following laparoscopic bariatric surgery. Conventional closure techniques often prove challenging and may lead to inadequate closure, increasing the risk of TSH. This study aimed to evaluate the effectiveness and safety of a novel omental plug technique for closing trocar sites in laparoscopic bariatric surgery. Methodology:A retrospective study included 256 patients who underwent laparoscopic bariatric surgery (LSG, OAGB, or RYGB) between 2019 and 2023 at Armed Forces Hospital, Taif, Saudi Arabia. We used an innovative omental plug technique to close trocar sites ≥10mm. The primary outcome was the incidence of TSH within 12 months postoperatively, assessed clinically and with an ultrasonography examination. Secondary outcomes included wound infections, seroma formation, and reoperation for trocar site complications. Results:We observed no cases of TSH, indicating significant efficacy in preventing this complication. Other postoperative complications were minimal, with only one case (0.4%) of a superficial wound infection. Conclusion:In laparoscopic bariatric surgery, the omental plug technique demonstrated promising results in preventing TSH and reducing postoperative complications. Its ease of use, safety profile, and potential biological advantages suggest it may be a valuable alternative to traditional fascial closure methods. We warrant future larger, multicentric studies with longer follow-up to confirm these findings.