Retrospective single-surgeon study of outcomes after laparoendoscopic single-site cholecystectomy and sigmoidectomy.
OBJECTIVE
Laparoendoscopic single-site (LESS) surgery is performed through a single port but requires a larger incision than conventional laparoscopy, which theoretically increases the risk of laparoscopic port hernia. Our primary objective is to determine the trocar site hernia rate among our patients.


METHODS
This retrospective study is based on the analysis of demographic, intraoperative, and postoperative data of 219 patients who underwent cholecystectomy or sigmoidectomy by LESS surgery between December 1st, 2009 and November 30th, 2012.


RESULTS
Cholecystectomy and sigmoidectomy LESS surgery were performed on 190 and 29 patients, respectively. Three patients developed a trocar site hernia within a median follow-up time of 34.7 months. Eleven patients were obese, 20 had a history of abdominal surgery, and 20 had a preoperative umbilical hernia but none of them developed a trocar site hernia, neither did the 11 subsequently pregnant women. Significant association was found between preoperative umbilical hernia and early complications including incisional cellulitis and hematoma.


CONCLUSIONS
A rate of 1.4% of trocar site hernia was observed in our study population. This rate is similar to the one reported after conventional laparoscopy. Peri-umbilical incision, longer than that with conventional laparoscopy, allowed better preexisting hernia handling, made anatomical closing easier among obese patients, and facilitated specimen extraction thus limiting traumatic operations.
Visceral Surgery Department, Groupe Hospitalier de la Rochelle Ré Aunis, rue du Dr Schweitzer, 17000, La Rochelle, France. alexandre.smirnoff@ch-larochelle.fr.
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A
Smirnoff
Clinique du Mail, 96 Allée du Mail, 17000, La Rochelle, France.
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L
de Poncheville
Clinical Research Unit, Groupe Hospitalier de la Rochelle Ré Aunis, rue du Dr Schweitzer, 17000, La Rochelle, France.
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C
Allix-Béguec
Visceral Surgery Department, Groupe Hospitalier de la Rochelle Ré Aunis, rue du Dr Schweitzer, 17000, La Rochelle, France.
P-Y
PY
Lefant
Clinique du Mail, 96 Allée du Mail, 17000, La Rochelle, France.
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E
Drapier
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D012809:Colon, Sigmoid / Q000601:surgery*; D004066:Digestive System Diseases / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006554:Hernia, Umbilical / Q000209:etiology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
Cholecystectomy; Hernia; Laparoscopy; Sigmoidectomy; Trocar