Umbilical Port Site Hernia and Diastasis Recti

Area of Science:

• Abdominal Surgery
• Hernia Repair
• Musculoskeletal Disorders

Background:

• Port site hernia (PSH) is an incisional hernia at trocar sites after laparoscopic surgery.
• Diastasis recti of the abdominis muscle (DR) involves rectus muscle separation.
• Understanding risk factors for PSH is crucial for surgical outcomes.

Purpose of the Study:

• To present experience with umbilical PSH and concomitant DR.
• To highlight DR as a potential risk factor for umbilical PSH.
• To increase awareness of DR's role in PSH development and recurrence.

Main Methods:

• Retrospective review of 18 patients with umbilical PSH post-laparoscopic surgery.
• Preoperative CT scans analyzed for Inter-recti distance (IRD).
• Analysis of factors including trocar size, BMI, port extension, and comorbidities.

Main Results:

• Port incision extension was linked to umbilical PSH.
• 56% of PSH patients had pre-existing DR; 50% showed sarcopenia.
• DR was associated with PSH recurrence, particularly multiple recurrences.

Conclusions:

• Port extension and sarcopenia are identified risk factors for umbilical PSH.
• DR may contribute to PSH occurrence and recurrence.
• Preoperative identification of DR via imaging is recommended; simultaneous correction of DR and PSH may be beneficial.