Incidence of early symptomatic port-site hernia: a case series from a department where laparoscopy is the preferred surgical approach.
BACKGROUND
Potential benefits of laparoscopic surgery include decreased post-operative pain, improved cosmesis and a shorter hospital stay. However as the volume and complexity of laparoscopic procedures increase, there appears to be a simultaneous increase in complications relating to laparoscopic access. Development of a port-site hernia is one such complication.


OBJECTIVE
The aim of this study was to evaluate our experience relating to the incidence, presentation and interventions for early, symptomatic port-site hernias following laparoscopic surgery in a unit where minimal access surgery is the preferred approach.


METHODS
A retrospective review of the medical records of all patients who underwent laparoscopic procedures performed by the colorectal service over a 3-year period was conducted. Patients who developed port-site hernias were identified. Additional information on patient demographics, patient co-morbidities, the length and nature of the laparoscopic procedure, the presenting symptoms, the timing of these symptoms as well as the relative investigations and interventions were recorded. All trocars used in this series were bladed.


RESULTS
A total of 647 patients underwent laparoscopic procedures over a 3-year period. Eight (1.23%) hernias were identified as occurring at the trocar entry site. All were symptomatic and all required surgical intervention.


CONCLUSIONS
Development of a port-site hernia in the early post-operative period can be associated with significant morbidity. This complication should be considered in patients presenting with post-operative bowel obstruction. With meticulous closure of port sites 10 mm and bigger, the incidence of hernia may be reduced.
Division of Colorectal Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. morandiarmaid@gmail.com
D C
DC
Moran
D O
DO
Kavanagh
S
S
Sahebally
P C
PC
Neary
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046449:Hernia, Abdominal / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors