title: Percutaneous trans-abdominal external looped needle with two holes in the trocar sheath for port-site closures in difficult obese cases.
abstract: BACKGROUND
  Port closure is essential after successful laparoscopic surgery to prevent incisional hernia. However, good fascial closure still represents a problem, especially in obese patients and when the port wound is oblique. We report a novel technique for port-site closures in such cases.
  
  
  METHODS
  This study involved 67 obese patients who underwent laparoscopic surgery. We used a novel technique for port-site closure that employed a looped needle passed through two holes in the port sheath.
  
  
  RESULTS
  The method was used in 67 patients (45 laparoscopic cholecystectomies, 22 laparoscopic hernia repairs), with a mean BMI of 35.7 kg/m2. No intraoperative incidents or port-site hernias were reported during follow-up (mean, 22 months).
  
  
  CONCLUSIONS
  Our procedure is safe, easy, and effective for fascial port site closures, especially in cases of difficult obese patients and oblique port wounds.
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt. lasheenahmed@yahoo.com.
authors.forename: Ahmed E
authors.initials: AE
authors.lastname: Lasheen
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Ayman
authors.identifier: http://orcid.org/0000-0002-8459-6504
authors.initials: A
authors.lastname: Salem
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Salah
authors.initials: S
authors.lastname: Abd Elaal
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Abd Elhafez
authors.initials: AE
authors.lastname: Elsheweal
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Gamal
authors.initials: G
authors.lastname: Osman
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alkilany
authors.affiliation: General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Ibrahim
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects / Q000295:instrumentation*; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D059685:Herniorrhaphy; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology / Q000517:prevention & control; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009339:Needles; D009765:Obesity / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*
keywords: Holes in trocar sheath; looped needle; port-site closure