Trocar site incisional hernias

Abstract

Objective: to analyse the incidence of trocar site hernias among patients admitted to the surgical clinic on an emergency basis with a diagnosis of an incarcerated hernia. Materials and methods. The retrospective and prospective study; the follow-up period is 10 years. A statistical analysis of patients with incarcerated hernias had been performed. A total of 1,448 subjects was selected for the study. Of these, 825 (57.0%) patients were diagnosed with incarcerated hernias of various localizations. The diagnosis of incarceration among 623 (43.0%) subjects proved to be false, and the hernias of these patients were classified as “reducible” and “irreducible” hernias. Results. An analysis of the operations revealed 34 patients with trocar site hernias, representing 2.34% of the total number of patients admitted to hospital with hernias and 4.93% of those operated on an emergency basis. Conclusion. The rare, partial incarceration of the omentum and small intestine, the so-called Richter’s hernia, after using 5-mm-diameter trocars was revealed in 4 people operated on previously (3 to 5 years). Moreover, the hernial orifice (abdominal wall defect) at the time of our operation turned out to be significantly larger than after puncture with a 5-mm trocar. A direct correlation was found between the incidence of trocar site hernia and the degree of obesity, body mass index.