World Journal of Laparoscopic Surgery

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VOLUME 3 , ISSUE 1 ( January-April, 2010 ) > List of Articles

REVIEW ARTICLE

Incisional Hernias after Laparoscopic Surgery

Mathews John

Citation Information : John M. Incisional Hernias after Laparoscopic Surgery. World J Lap Surg 2010; 3 (1):13-17.

DOI: 10.5005/jp-journals-10007-1075

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To review about incisional hernia following laparoscopic abdominal surgery and the relationship between the pathogenesis and clinical features and manifestation of trocar site hernias.

Methods

We searched for this subject on Medline and Google search by combining all these words like “trocar,” “port,” “hernia, and “laparoscopy.”

Results

We were not able to find a common factor that analyzed the factors related to trocar site hernia by multivariate analysis. Therefore, we could not indicate the only independent risk factor. However, we have referred to many reports that have logically indicated pathogenesis. The literature what we have gone through frequently point out that the main pathogenesis is not host factors but rather technical ones; besides, most accurate reason is that a large trocar size, leaving the fascial defect open, and stretching the port site were closely related to the occurrence of trocar site hernias.

Conclusion

The highlight of this review article is that the drain sites can possibly be one of the sources for bowel complications. We recommend closure of all 10 mm ports. If an intraperitoneal drain is necessary, it should be placed through a 5 mm port only.


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  1. Minimally invasive surgery. Endoscopy 2001;33:358-66.
  2. Prevalence and mechanisms of small intestinal obstruction following laparoscopic abdominal surgery: A retrospective multicenter study. Arch Surg 2000;135:208-12.
  3. Complications of laparoscopic general surgery. Gastrointest Endosc Clin N Am 1996;6:423-44.
  4. Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg 1995;61:718-20.
  5. Laparoscopy: A valuable aid in gynecologic diagnosis. Obstet Gynecol 1968;31:297-309.
  6. Laparoscopic trocar site hernias. J Laparoendosc Surg 1993;3:567-70.
  7. Incisional hernias after laparoscopy. Obstet Gynecol Surv 1997;52:701-03.
  8. Incisional hernias after laparoscopic vs open cholecystectomy. Surg Endosc 1999;13:922-24.
  9. CT diagnosis of post laparoscopic hernia. J Comput Assist Tomogr 1991;15:1054-55.
  10. Complications of laparoscopic surgery. Surg Clin North Am 1993;73:265-89.
  11. Incisional hernias after major laparoscopic gynecologic procedures. Am J Obstet Gynecol 1993;168:1493-95.
  12. Subumbilical hernia following laparoscopic cholecystectomy. Br J Surg 1993;80:1595.
  13. Herniation of the small bowel through the port site following removal of drains during laparoscopic surgery. Dig Surg 2000;17:544-46.
  14. Incisional hernia and fascial defect following laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 2000;10:34-38.
  15. Preperitoneal Richter hernia after a laparoscopic gastric bypass. Surg Laparosc Endosc Percutan Tech 2001;11:47-49.
  16. Preperitoneal herniation into a laparoscopic port site without a fascial defect. Obes Surg 2002;12:121-23.
  17. A practical approach to laparoscopic cholecystectomy. Am J Surg 1991;161:365-70.
  18. Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients. Am J Surg 1992;163:221-26.
  19. An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital. Am Surg 1992;58:206-10.
  20. Complications of laparoscopic cholecystectomy: The experience of a universityaffiliated teaching hospital. J Laparoendosc Adv Surg Tech A 1997;7:29-35.
  21. Incidents and postoperative complications of laparoscopic cholecystectomies for acute cholecystitis. Rom J Gastroenterol 2002;11:115-19.
  22. Risks of the minimal access approach for laparoscopic surgery: Multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg 1997;21:529-33.
  23. Laparoscopic colorectal surgery for cancer: Intermediate to long-term outcomes. Dis Colon Rectum 2002;45:867-72.
  24. Elective laparoscopic management of sigmoid diverticulitis: Results in a series of 110 patients. Surg Endosc 1999;13:457-60.
  25. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232:515-29.
  26. Establishing a laparoscopic gastric bypass program. Am J Surg 2002;184:617-20.
  27. Adjustable gastric banding in a public university hospital: Prospective analysis of 400 patients. Obes Surg 2002;12:93-99.
  28. Laparoscopic cholecystectomy and the umbilicus. Br J Surg 1997;84:630-33.
  29. Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication. Surg Endosc 2001;15:663-66.
  30. Laparoscopic repair of access port site hernia after Lap-Band system implantation. Obes Surg 2002;12:682-84.
  31. Gallbladder and gallstone removal, open versus closed laparoscopy, and pneumoperitoneum. Am J Surg 1993;165:497-504.
  32. Incarcerated hernia with intestinal obstruction after laparoscopic cholecystectomy. WMJ 1994;93:169-71.
  33. Small bowel obstruction after laparoscopic cholecystectomy as a result of a Maydl's herniation of the small bowel through a trocar site. Surgery 1996;119:480.
  34. Incarcerated paraumbilical incisional hernia and abscess: Complications of a spilled gallstone. J Laparoendosc Surg 1995;5:189-91.
  35. Richter's hernia in the laparoscopic era: Four case reports and review of the literature. Surg Laparosc Endosc Percutan Tech 2003;13:55-58.
  36. Incisional hernia following laparoscopy: A survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol 1994;84:881-84.
  37. Herniation at the site of cannula insertion after laparoscopic cholecystectomy. Br J Surg 1993;80:915.
  38. Small bowel obstruction due to Richter's hernia after laparoscopic procedures. J Laparoendosc Surg 1993;3:421-23.
  39. Postoperative bowel obstruction following laparoscopic surgery. Am Surg 1993;59:656-57.
  40. Early incisional hernia after use of the 12 mm port for laparoscopic surgery. Aust NZJ Surg 1993;63:574-75.
  41. Small bowel obstruction following laparoscopic cholecystectomy: Diagnosis of incisional hernia by computed tomography. Surg Laparosc Endosc 1994;4:325-26.
  42. Small-bowel obstruction due to hernia through the primary laparoscopic port: A complication of laparoscopic cholecystectomy. AJR Am J Roentgenol 1994;163:480-81.
  43. Large postoperative umbilical hernia following laparoscopic cholecystectomy: A case report. Surg Endosc 1994;8:904-05.
  44. Richter hernia: A rare complication of laparoscopy. Surg Laparosc Endosc 1995;5:419-21.
  45. Incisional hernia via a lateral 5 mm trocar port following laparoscopic cholecystectomy. Isr J Med Sci 1996;32:790-91.
  46. Incisional hernia in a 5 mm trocar site following pediatric laparoscopy. J Laparoendosc Surg 1996;6(suppl 1):S89-S90.
  47. Revision laparoscopy for incarcerated hernia at a 5 mm trocar site following pediatric laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 1999;9:294-95.
  48. Hernia at 5 mm laparoscopic port site presenting as early postoperative small bowel obstruction. J Laparoendosc Adv Surg Tech A 1999;9:523-25.
  49. Intra-abdominal gallstone spillage detected during umbilical trocar site hernia repair after laparoscopic cholecystectomy: Report of a case. Surg Today 2000;30:1046-48.
  50. Soft-tissue images: Trocar-site hernia after laparoscopic procedures. Can J Surg 2002;45:9-10.
  51. Postlaparoscopic small bowel obstruction: Rethinking its management. Surg Endosc 1998;12:1043-45.
  52. Clinical experience with open laparoscopy. J Laparoendosc Adv Surg Tech A 1997;7:285-88.
  53. Umbilical hernial defects encountered before and after abdominal laparoscopic procedures. Int Surg 1998;83:171-73.
  54. The 2 mm trocar: A safe and effective way of closing trocar sites using existing equipment. J Am Coll Surg 2003;196:333-36.
  55. Regarding: Small bowel obstruction and incisional hernia after laparoscopic surgery: Should 5 mm trocar sites be sutured? J Laparoendosc Adv Surg Tech A 2000;10:227-28.
  56. Lateral laparoscopic port sites should all be closed: The incisional “spigelian” hernia. Surg Endosc 2002;16:1364.
  57. A simple technique for trocar site closure after laparoscopic surgery. Surg Endosc 1999;13:1249-51.
  58. Closure of trocar wounds using a suture carrier. Surg Laparosc Endosc 1996;6:469-71.
  59. Port-site closure: A new problem, an old device. JSLS 2002;6:181-83.
  60. Laparoscopic port sites do not require fascial closure when nonbladed trocars are used. Am Surg 2000;66:853-54.
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