title: Randomized prospective trial on the occurrence of laparoscopic trocar site hernias.
abstract: BACKGROUND
  Laparoscopy has become the gold standard in an increasing number of procedures. We analyze the incidence of trocar site hernias (TSH) and determine whether closure of the external fascia prevents onset of TSH and possible complications.
  
  
  METHODS
  We performed a simple-blind randomized trial with two groups, one in which all the orifices were closed by suturing the external fascia of the abdominal wall (group A), and another in which the orifices were left open, closing only the skin (group B). Monitoring for TSH lasted 2 years from the intervention. The trial has been registered at www.clinicaltrials.gov with the clinicaltrials.gov identifier number: NCT01240434.
  
  
  RESULTS
  A total of 195 patients were randomized. Thirty-three were removed from the study after conversion to open surgery, early open reoperation, or loss to follow-up. The remaining 162 patients comprised the study population, 80 in group A and 82 in group B. We found no differences between the groups regarding basic demographic data, kind of surgery, or topographic distribution of the trocars. Five TSH were diagnosed-four in group A and one in group B (P=.176)-and there was no relation between TSH and trocar size (11 or 12 mm) or location. We found 10 wound infections, 7 in group A and 3 in group B (P=.154).
  
  
  CONCLUSIONS
  Our study suggests that the onset of TSH does not depend on trocar size or location. There is no evidence that suture of the fascial defect prevents the onset of TSH. In addition, we found a trend toward a higher incidence of wound infection among patients in whom the fascia had been sutured.
authors: Servicio de Cirugía General II, Hospital General Universitario Gregorio Marañón, Madrid, Spain. jesus.lago@salud.madrid.org
authors: Jesús
authors: J
authors: Lago
authors: Daniel
authors: D
authors: Serralta
authors: Andrés
authors: A
authors: García
authors: Jorge
authors: J
authors: Martín
authors: Mercedes
authors: M
authors: Sanz
authors: Maria Dolores
authors: MD
authors: Pérez
authors: Fernando
authors: F
authors: Turégano
mesh_terms: D000071938:Fasciotomy; D005260:Female; D046449:Hernia, Abdominal / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013525:Surgical Instruments