No Need of Fascia Closure to Reduce Trocar Site Hernia Rate in Laparoscopic Surgery: A Prospective Study of 200 Non-Obese Patients
| Autor: | Rikki Singal, Muzzafar Zaman, Samita Singal, Anshu Mittal, Amit Mittal, Karamjot Sandhu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Incisional hernia medicine.medical_treatment Lap cholecystectomy 03 medical and health sciences Port fascia closure 0302 clinical medicine Blunt medicine Hernia Laparoscopy Hernias medicine.diagnostic_test business.industry Fascia medicine.disease Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Abdomen 030211 gastroenterology & hepatology Cholecystectomy Original Article business Laparoscopic visualization |
| Zdroj: | Gastroenterology Research |
| ISSN: | 1918-2813 1918-2805 |
| Popis: | Background: Laparoscopy is widely practiced and offers realistic benefits over conventional surgery. Port closure is important after a laparoscopic procedure to prevent port site incisional hernia. Larger port size and increasing numbers of ports needed to perform more complex laparoscopic procedures are likely to increase the incidence of port site hernias (PSHs). PSHs tend to develop more frequently at umbilical and midline port sites due to the thinness of the umbilical skin and weaknesses in the linea alba. More than 90% of PSHs occur through 10 mm and large ports can occur through 5 mm ports also. The aim was to study the outcomes and complications in laparoscopic surgery without fascial sheath closure of port site. We compared the results with another group in which fascial closure was done by a standard method. Methods: This was a prospective study carried out in the Department of Surgery, MMIMSR, Mullana, Ambala, from August 2013 to 2015 in a single unit by a single surgeon. A total of 200 patients were selected randomly for the different laparoscopic procedures. Patients were divided into group A (only skin closure was done without fascia closure) and group B (fascial closure of the port in addition to skin closure). In both groups, we used blunt trocar for the 10 mm port. Skin of the 5 mm port was closed simply. The results in two groups were compared in terms of complications like PSH, bleeding, and wound infection. Results: The outcomes in two groups were compared with and without fascia closure of 10 mm trocar port site. Patients operated for lap cholecystectomy were 170 (85%), 10 (5%) for lap appendicectomy, and 20 (10%) for lap hernia. The study compared the results in two groups mainly for PSH formation. The P value was insignificant and Fischer’s exact test result came as 1.00. There were no significant differences between the two groups in terms of PSH, bleeding and infection in non-obese cases. Conclusion: In both groups, blunt trocar was introduced into the abdomen. We concluded that this is safe, without visceral injury, and no bleeding was seen in both the groups. We had not encountered any case with PSH formation in follow-up of 6 - 8 months. There was no infection over the port site. Gastroenterol Res. 2016;9(4-5):70-73 doi: http://dx.doi.org/10.14740/gr715w |
| Databáze: | OpenAIRE |
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