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A Comprehensive Review of Port-Site Closure Methods: A Four-Decade-Challenge to an Unsolved Issue
Renato Costi1,2, Alessandro Facchinetti1, Manuel Baldinu1
1Department of Medicine and Surgery, University of Parma, Parma, Italy. (Drs. Costi, Facchinetti, Baldinu, Foresti, Annicchiarico).
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 6, 2026
Summary
Laparoscopic surgery relies on effective trocar-site closure to prevent hernias and bleeding. Current closure methods lack a gold standard, necessitating further research for optimal patient outcomes.
Area of Science:
- Minimally Invasive Surgery
- Surgical Complications
- Hernia Repair
Background:
- Laparoscopic surgery offers benefits like reduced pain and faster recovery.
- International guidelines recommend closing ≥10-mm trocar sites.
- Ineffective closure can lead to trocar-site hernias (TSH) and bleeding.
Purpose of the Study:
- To assess the current state of port-site closure techniques and devices in 2026.
- To review methods for closing trocar sites in laparoscopic surgery.
- To identify gaps in current knowledge and practice.
Main Methods:
- Systematic literature review of articles on port-site closure.
- Classification of methods according to Shaher's classification.
- Discussion of risk factors, clinical evidence, and surgical practice.
Main Results:
- 36 articles included from 1,251 screened.
- Trocar-site hernia (TSH) recurrence was rare (0.2%).
- Operative time varied significantly; follow-up averaged 21.2 months.
Conclusions:
- No single port-site closure method demonstrates clear superiority.
- The quality of existing literature is low, with inconsistent outcomes.
- A gold-standard approach is absent; standardized comparative studies are needed.
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