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[Trocar site herniation (TSH) following laparoscopic cholecystectomy: incidence, pathogenesis, and prevention --
Eldin Mohamed Gamal1, Györgyi Szabó, Péter Metzger
1Europ-Med Budaörs Egészségügyi Központ Egynapos Sebészeti Osztály 2040 Budaörs Kossuth Lajos u. 9.
Introduction:
In 1968 R. E. Fear first reported a trocar site hernia (TSH) in his large series on laparoscopy. Currently, the incidence of TSH is estimated to be 0.65-2.80%. Ports ≥10-mm are usually closed, but ports of the 5-mm trocars are always left open, which may lead to herniation.
Material And Methods:
Authors guided teaching courses for hands-on animal laparoscopic cholecystectomy (LC) operations, where trainees performed LC-s on 60 animals. Two and four weeks following the operations the animals underwent second look laparoscopy to detect adhesion formation.
Results:
Trocar site herniation was observed, and in 20% of the animals herniation was found. 70% of the hernias were situated in the 5-mm ports and 30% in the 10-mm ports.
Conclusion:
Port sites should be closed to prevent the formation of TSH. Attention should be payed on the closure of 5-mm trocar sites as well.
