OBJECTIVES:Port-site hernias are a rare complication occurring in approximately 1% of all laparoscopic surgeries.
With the use of bladeless, blunt-tipped entry trocars, some surgeons have argued that not all port sites require fascial closure. However, several cases of port-site hernia have recently been reported with the use of bladeless trocars. This study evaluated the incidence of port-site hernias following robot-assisted radical prostatectomy (RARP) as we routinely closed the fascial of only the midline 12-mm port site.
PATIENTS AND METHODS: From 2006 to 2009, 498 patients with localized prostate cancer underwent RARP. Bladeless dilating trocars were used in all of our patients. Routinely, six ports were used: two 12 mm, three 8 mm, and one 5 mm. Fascial closure was performed only for the midline supraumbilical 12-mm port site.
RESULTS: In 498 cases of RARP, there were two port-site hernias (0.4%, 2/498). Both cases occurred at the midline supraumbilical 12-mm camera port site. No hernia developed at non-midline port sites, including the lateral 12-mm port site.
CONCLUSION: Trocar site hernias following RARP are rare. When bladeless dilating trocars are used, routine closure of fascia of non-midline 12-mm or smaller port sites is not necessary. Splitting the muscle and fascia without cutting likely renders routine closure of fascia unnecessary for non-midline ports that are ≤ 12 mm.
Written by:
Kang DI, Woo SH, Lee DH, Kim IY. Are you the author?
United States.
Reference: J Endourol. 2012 Jan 27. Epub ahead of print.
doi: 10.1089/end.2011.0630
PubMed Abstract
PMID: 22283233
