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Related Experiment Videos

Incisional hernias after operative laparoscopy

C Nezhat1, F Nezhat, D S Seidman

  • 1Department of Surgery, Stanford University School of Medicine, California, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|April 1, 1997
PubMed
Summary

Incisional hernias after laparoscopy are rare (0.2%), but can occur through small incisions. Closing fascia and peritoneum is recommended, even for 5-mm trocar sites with extensive manipulation, to prevent hernias.

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Surgery
  • Abdominal Wall Reconstruction

Background:

  • Incisional hernias are a known complication of abdominal surgery.
  • Laparoscopic surgery, while minimally invasive, can still pose risks for hernia formation.
  • Previous recommendations focused on larger trocar sites for fascial closure.

Purpose of the Study:

  • To identify risk factors for incisional hernias following laparoscopic procedures.
  • To evaluate the incidence and characteristics of incisional hernias after laparoscopy.
  • To refine recommendations for preventing incisional hernias in laparoscopic surgery.

Main Methods:

  • Retrospective case review of approximately 5300 laparoscopic surgeries.
  • Analysis of 10 patients who developed incisional hernias.

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  • Evaluation of hernia contents, location, and surgical factors.

    • Main Results:

    • An overall incidence of incisional hernias was approximately 0.2% (11 hernias in 10 patients).
    • Hernias occurred through 5-mm trocar sites in five cases.
    • Omentum and bowel were the most common herniated contents; some required surgical repair.

    Conclusions:

    • Incisional hernias can occur even with small (5-mm) trocar sites, particularly with extensive manipulation.
    • Fascial and peritoneal closure is crucial for all trocar sites, regardless of size, to prevent hernias.
    • Recommendations for port site closure should be updated to include 5-mm ports with significant manipulation.