[Incisional hernia at the trocar site in laparoscopic surgery]

The main aim of this study was to evaluate the incidence of incisional hernia at the trocar site, as well as to contribute towards defining the etiopathogenetic factors responsible. One hundred and fifty cases of patients undergoing laparoscopic surgery were studied retrospectively from the clinical and ultrasonographical points of view. The laparoscopic gaps examined numbered approximately 600 in all. The incidence of incisional hernia was 2%, exclusively located in the periumbilical area. There were no incisional hernias in extra-umbilical areas, which we usually do not suture. A symptomatic extra-umbilical incisional hernia occurred at a 5 mm site in a patient previously operated on in another hospital. Particular attention needs to be paid to periumbilical gap suture, exposed to the trauma of trocar fixing, especially in obese and diabetic patients. In selected cases the other gaps should be sutured, including the 5 mm ones.