Laparoscopic trocar site hernias

Five patients with laparoscopic trocar site incisional hernias are presented. These occurred following laparoscopic cholecystectomy (4) and pelvic laparoscopy (1). The hernias appeared from 1 week to 4 months postoperatively. Both 5-mm and 10-mm fascial defects were involved. Hernias occurred only in the abdominal midline. The brief literature on this complication is reviewed, and recommendations for hernia prevention are suggested. The use of laparoscopy for more complex procedures will result in an increased incidence of trocar site hernias. Suture closure of the larger fascia defects will minimize this complication. Other techniques for hernia prevention have been described but never have been rigorously tested.