title: Effective, simple, easy procedure for laparoscopic port closure in difficult cases.
abstract: BACKGROUND
  Laparoscopic and rebotic surgery is widely practiced in modern medicine. The operative procedure is not complete until the port sites are closed with a fascial closure. Good fascial closure still represents problem, especially in difficult obese patients. This study reported simple technique is suitable in such cases.
  
  
  METHODS
  We herein describe a simple technique for fascial closure after Laparoscopic surgery using percutaneous transabdominal approach by using two looped needles in 87 obese patients. This technique was done while the trocar sheath in its position.
  
  
  RESULTS
  The procedure was used in 87 patients (69 females and 18 males) after laparoscopic cholecystectomy with mean body mass index 35.5 kg/m2 and mean age 47.1 years from May 2013 through June 2015. No intra-operative incidents and no port sites hernias were reported during a mean follow up of 18 months.
  
  
  CONCLUSIONS
  The procedure is easy to perform, safe, and effective for fascial port site closure in difficult obese (thick abdominal wall and oblique port wound) cases.
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Ahmed E
authors.initials: AE
authors.lastname: Lasheen
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Safwat
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: AbdElhafez
authors.initials: A
authors.lastname: Elsheweal
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Ramadan
authors.initials: R
authors.lastname: Mahmoud
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alkilany
authors.affiliation: General, Laparoscopic Department, Zagazig University Hospital, Zagazig University, 44519, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Ismaeil
keywords: External looped needles; Laparoscopic port site closure