Minimizing trochar site herniation in laparoscopic cholecystectomy

The technique for laparoscopic cholecystectomy (LC) was originally devised and described has remained unchanged because of its efficacy. LC involves a 10-mm trochar in periumbilical region, 10-mm trochar in the epigastrium, and two 5-mm trochars at the right anterior axillary line and right midclavicular line. The exposure and dissection provided by the instruments placed through these trochars is usually adequate and the necessity for additional ports is rare. Our technique modification eliminates the epigastric 10-mm port and replaces it with a 5-mm epigastric port and also eliminates one of the lateral 5-mm ports. Recent articles have reported a significant incidence of Richter's or incisional hernias at the trochar sites. Our modification of the standard technique has the advantage of eliminating a potential incisional hernia at the epigastric port site and further improvement of cosmetic result.