Trocar-site hernia as a typical postoperative complication of minimally invasive surgery among preschool children.
BACKGROUND
Minimally invasive surgery (MIS) in preschool children (<5 years of age) is not common yet, and few reports evaluating typical complications are available. Trocar site hernias are well described in adult patients but also have been reported for preschool children. The goal of our study was to determine incidence and relevance of trocar site hernias as complications of minimally invasive surgery in preschool children.


METHODS
Retrospective analysis of all pediatric patients who underwent minimally invasive surgery at a single institution. Review of the literature.


RESULTS
Trocar site hernias are significantly more frequent in preschool children than in older ones (p = 0.006). Complication rates at all are not significantly different. Trocar site hernias in infants are mainly of type 3 (omental protrusion) and occur within the first postoperative week.


CONCLUSIONS
Meticulous suturing of all layers (particularly the peritoneum) even in small incisions (2 mm) is recommended to prevent omental protrusion at trocar site in children up to 5 years of age.
Paya
K
K
Department of Surgery, Medical University of Vienna, Waehringerguertel 18-20, Vienna, Austria. kurosh.paya@meduniwien.ac.at
Wurm
J
J
Fakhari
M
M
Felder-Puig
R
R
Puig
S
S
D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D006555:Hernia, Ventral / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D009852:Omentum; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011677:Punctures / Q000009:adverse effects* / Q000295:instrumentation; D012189:Retrospective Studies; D013525:Surgical Instruments; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D013536:Suture Techniques