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Laparoscopic trocar site hernias

W J Plaus1

  • 1Department of Surgery, Rose Medical Center, Denver, Colorado.

Journal of Laparoendoscopic Surgery
|December 1, 1993
PubMed
Summary

Laparoscopic surgery can lead to incisional hernias at trocar sites, especially with larger defects. Suture closure of fascial defects is recommended to minimize this risk.

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Area of Science:

  • Surgical complications
  • Minimally invasive surgery

Background:

  • Laparoscopic surgery is increasingly used for various procedures.
  • Trocar site incisional hernias are a known complication of laparoscopy.
  • These hernias can occur at fascial defects created during surgery.

Observation:

  • Five cases of laparoscopic trocar site incisional hernias are presented.
  • Hernias occurred after laparoscopic cholecystectomy and pelvic laparoscopy.
  • Defects ranged from 5-mm to 10-mm and were located in the abdominal midline.
  • Hernias appeared between 1 week and 4 months postoperatively.

Findings:

  • Trocar site hernias are associated with both small (5-mm) and large (10-mm) fascial defects.
  • The incidence of these hernias may increase with more complex laparoscopic procedures.
  • Midline abdominal locations appear to be particularly susceptible.

Implications:

  • Suture closure of larger fascial defects (≥10 mm) is crucial for preventing trocar site hernias.
  • Further research and rigorous testing are needed for other proposed hernia prevention techniques.
  • Minimally invasive surgery requires careful attention to potential complications like incisional hernias.

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