Trocar site hernia after gastric sleeve

Area of Science:

• Bariatric Surgery
• Minimally Invasive Surgery
• Surgical Complications

Background:

• Trocar site hernia (TSH) is an underestimated complication of laparoscopic abdominal surgery.
• Risk factors for TSH include obesity, large trocar use, and the umbilical site.
• Previous studies identified CT scans in prone position as reliable for TSH detection post-gastric bypass.

Purpose of the Study:

• To determine the incidence of TSH after laparoscopic gastric sleeve (LGS).
• To investigate the proportion of symptomatic TSH in LGS patients.
• To compare TSH incidence after LGS with previous findings after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Main Methods:

• Seventy-nine patients undergoing LGS between 2011-2016 were evaluated.
• Computed tomography (CT) scans in the prone position were used to detect TSH.
• Patient-reported symptoms of TSH were collected via a digital survey.

Main Results:

• The incidence of TSH was 21.5% (17 out of 79 patients), exclusively at the umbilical trocar site.
• The mean follow-up duration was 37 months.
• No significant correlation was found between patient-reported symptoms and the presence of TSH.

Conclusions:

• The incidence of TSH following LGS is notably high, consistent with other recent research and prior studies on LRYGB.
• No patients required hernia repair during the follow-up period.
• Further investigation is needed to clarify the proportion and clinical significance of symptomatic TSH.