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Trocar site hernia after bariatric surgery: our experience without fascial closure.
Int J Surg 2014; 12 Suppl 1:S83-6IJ

Abstract

INTRODUCTION

The spreading of laparoscopic surgery has increased the occurrence of trocar site hernias, along with their related complications. Bariatric surgery combines two important risk factors in hernia formation: obesity and complexity of port-site closure. Several techniques and devices have been proposed to close the trocar wounds to minimize the risk of hernia occurrence.

MATERIALS AND METHODS

The records of 624 obese patients who underwent laparoscopic bariatric procedures between January 2006 and December 2012 were retrospectively reviewed. In no patient was performed the closure of the fascial layers of trocar incisions. Weight, BMI, E%WL and onset of complications were monthly collected for the first year after the procedure, then every six month.

RESULTS

10 patients showed trocar site hernia, for an overall prevalence of 1.6%. The mean time of occurrence was 15 months. None developed intestinal obstruction or other complications as a consequence of the hernia. The mean time of follow-up was 54 months. The mean weight and BMI before interventions were 136.3 ± 17.7 kg and 46.0 ± 4.6 kg/m² respectively. The mean percentage of excess weight loss (E%WL) at one year was 45.9%.

CONCLUSION

We avoided complicating the wound closure with fascia closure, accepting the risks related to the BMI. So far our procedure for port-site closure is relatively simple, safe, less invasive, less time-consuming and costless. These advantages could arise from the fact that our patients benefit from a remarkable weight loss after the intervention thus reducing one of the most important risk factors in the onset of trocar site hernia.

Authors+Show Affiliations

Department of Medicine and Surgery, University of Salerno, Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy. Electronic address: ariolahasani@libero.it.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

24862661

Citation

Pilone, Vincenzo, et al. "Trocar Site Hernia After Bariatric Surgery: Our Experience Without Fascial Closure." International Journal of Surgery (London, England), vol. 12 Suppl 1, 2014, pp. S83-6.
Pilone V, Di Micco R, Hasani A, et al. Trocar site hernia after bariatric surgery: our experience without fascial closure. Int J Surg. 2014;12 Suppl 1:S83-6.
Pilone, V., Di Micco, R., Hasani, A., Celentano, G., Monda, A., Vitiello, A., ... Forestieri, P. (2014). Trocar site hernia after bariatric surgery: our experience without fascial closure. International Journal of Surgery (London, England), 12 Suppl 1, pp. S83-6. doi:10.1016/j.ijsu.2014.05.047.
Pilone V, et al. Trocar Site Hernia After Bariatric Surgery: Our Experience Without Fascial Closure. Int J Surg. 2014;12 Suppl 1:S83-6. PubMed PMID: 24862661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trocar site hernia after bariatric surgery: our experience without fascial closure. AU - Pilone,Vincenzo, AU - Di Micco,Rosa, AU - Hasani,Ariola, AU - Celentano,Giuseppe, AU - Monda,Angela, AU - Vitiello,Antonio, AU - Izzo,Giuliano, AU - Iacobelli,Leucio, AU - Forestieri,Pietro, Y1 - 2014/05/23/ PY - 2014/03/23/received PY - 2014/05/03/accepted PY - 2014/5/28/entrez PY - 2014/5/28/pubmed PY - 2015/7/15/medline KW - Bariatric surgery KW - Incisional hernia KW - Laparoscopy KW - Obesity KW - Trocar site SP - S83 EP - 6 JF - International journal of surgery (London, England) JO - Int J Surg VL - 12 Suppl 1 N2 - INTRODUCTION: The spreading of laparoscopic surgery has increased the occurrence of trocar site hernias, along with their related complications. Bariatric surgery combines two important risk factors in hernia formation: obesity and complexity of port-site closure. Several techniques and devices have been proposed to close the trocar wounds to minimize the risk of hernia occurrence. MATERIALS AND METHODS: The records of 624 obese patients who underwent laparoscopic bariatric procedures between January 2006 and December 2012 were retrospectively reviewed. In no patient was performed the closure of the fascial layers of trocar incisions. Weight, BMI, E%WL and onset of complications were monthly collected for the first year after the procedure, then every six month. RESULTS: 10 patients showed trocar site hernia, for an overall prevalence of 1.6%. The mean time of occurrence was 15 months. None developed intestinal obstruction or other complications as a consequence of the hernia. The mean time of follow-up was 54 months. The mean weight and BMI before interventions were 136.3 ± 17.7 kg and 46.0 ± 4.6 kg/m² respectively. The mean percentage of excess weight loss (E%WL) at one year was 45.9%. CONCLUSION: We avoided complicating the wound closure with fascia closure, accepting the risks related to the BMI. So far our procedure for port-site closure is relatively simple, safe, less invasive, less time-consuming and costless. These advantages could arise from the fact that our patients benefit from a remarkable weight loss after the intervention thus reducing one of the most important risk factors in the onset of trocar site hernia. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/24862661/Trocar_site_hernia_after_bariatric_surgery:_our_experience_without_fascial_closure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(14)00146-0 DB - PRIME DP - Unbound Medicine ER -