Laparoscopic management of drain-site incisional hernias following laparotomies--a simple suture technique.
BACKGROUND
Herniation through drain sites is a rare but recognized complication of surgical drainage and are actually considered to be a type of incisional hernia. Incisional hernias form following surgery through the incision site or previous drain sites, or through laparoscopic trocar insertion sites.


METHODS
In this paper, we present 13 such patients with incisional hernia of the main laparotomy wound and at the drain site, and 1 patient with an isolated drain-site hernia. A laparoscopic meshplasty with a simple suturing of the drain-site defect was performed.


CONCLUSIONS
Incisional hernias are reported to occur in approximately 4%-10% of patients following open surgical procedures. There are several studies that have proven the efficacy of laparoscopic repair of incisional hernias, when compared to open procedures. The main predisposing factor regarding incisional hernias is probably the presence of a sepsis during the previous laparotomy, which was why the drainage tube was kept in the first place.


CONCLUSIONS
The laparoscopic approach is useful for repairing the main incisional hernia, as well as drain-site hernias, simultaneously. We cut costs by avoiding tacking devices and use intracorporeal suturing instead.
Palanivelu
Chinnusamy
C
Department of Minimal Access Surgery, GEM Hospital, Coimbatore, India.
Rangarajan
Muthukumaran
M
Senthilkumar
Rangaswamy
R
John
Suviraj
S
Madankumar
Madhupalayam Velusamy
MV
D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D000368:Aged; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D013526:Surgical Mesh; D013536:Suture Techniques; D013537:Sutures