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Long-term follow-up after single-incision laparoscopic surgery.

Atakan Görkem Barutcu1, Denis Klein1, Maik Kilian1,2

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Summary

Single-incision laparoscopic surgery (SILS) is safe for appendectomy and cholecystectomy. Long-term follow-up shows obesity and prior hernias increase incisional hernia risk after SILS.

Keywords:
AppendectomyCholecystectomySILSSingle incisionSingle port

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Abdominal Surgery

Background:

  • Single-incision laparoscopic surgery (SILS) is gaining traction.
  • Concerns exist regarding increased incisional hernia risk due to larger umbilical incisions in SILS compared to conventional laparoscopy.

Purpose of the Study:

  • To determine the long-term frequency of incisional hernias following SILS.
  • To identify patient-specific and operative factors that predispose individuals to incisional hernias after SILS.

Main Methods:

  • Analysis of 286 patients undergoing SILS for cholecystectomy or appendectomy.
  • Long-term follow-up via correspondence, interviews, and clinical examinations.
  • Investigation of demographic and operative variables using univariate and multivariate analyses.

Main Results:

  • Incisional hernia developed in 2.4% of patients over a mean follow-up of 58.4 months.
  • Obesity (10.9% incidence) and pre-existing umbilical hernia (15.8% incidence) were significantly associated with incisional hernia.
  • No significant association found for age, sex, procedure type, or surgery duration.

Conclusions:

  • Long-term monitoring is crucial for detecting incisional hernias post-SILS.
  • Obesity and prior umbilical hernias are key risk factors for incisional hernias after SILS.
  • SILS is a safe surgical option for appendectomy and cholecystectomy with careful patient selection.