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

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.