Trocar site hernia after laparoscopic bariatric surgery: Incidence with non‐fascial closure

Abstract

Objective The aim of this study was to determine the incidence of trocar site hernia (TSH) after minimally invasive bariatric surgery in the setting of non-fascial closure and to assess the possible predisposing factors. Methodology Two hundred four patients who underwent laparoscopic bariatric surgery between May 2015 and December 2019 were retrospectively reviewed and were asked for a follow-up visit. All patients were examined clinically and underwent an abdominal ultrasound (US) for detection of any TSH. Results Trocar site hernia was detected in three patients (1.4%), all of them occurred after laparoscopic sleeve gastrectomy (LSG). The three TSH developed at the 12-mm port site. The mean time of TSH occurrence was 13 months postoperatively. Two cases were asymptomatic and discovered on US evaluation while the third was symptomatic. The mean time of follow-up was 40 months, range (13–67 month). In our study, age, sex, preoperative BMI and comorbidities had no significant statistical relation with TSH; however, postoperative wound infections and smoking were statistically significant predisposing risk factors for TSH. Conclusions Trocar wound sites skin closures without fascial closure were associated with a low rate of TSH (1.4%) and all cases were related to 12 mm trocar size.