Port-site hernia: An individualized approach to port closure

Abstract Background The incidence of port site hernia (PSH) after laparoscopic surgery can reach up to 4 %. The fascial closure at the port site can be challenging in some cases.Methods A multi-center, prospective, open label study to evaluate a new integrated port closure system (Gordian TroClose™ 1200 by Gordian Surgical™), is presented.Results Fifty patients were enrolled in the study. All enrolled patients underwent laparoscopic surgery, during which at least one TroClose1200 device was used per patient. Patients were followed for two and six weeks and for one year. No port PSH related to TroClose 1200 device was diagnosed at one year of follow-up. One PSH was diagnosed at a non-TroClose1200 trocar site. The surgeons were very satisfied with the new device’s performance, with an average range of 4.8-5.0 out of 5.0 usability question being above 4.80 out of 5. No severe adverse events or device related adverse events were observed.Conclusions The TroClose 1200 is a simple, safe and friendly device that may reduce the incidence of port site hernia.

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Use of a novel integrated port closure system - A multi-center study

10.21203/rs.3.rs-25318/v2 ◽

2021 ◽

Author(s):

Qarawany Milad ◽

Hagar Mizrahi ◽

Surendra Ugale ◽

Guy Pascal ◽

David Hazzan

Keyword(s):

Laparoscopic Surgery ◽

Adverse Events ◽

Port Site ◽

Fascial Closure ◽

Closure System ◽

Open Label ◽

Trocar Site ◽

Port Closure ◽

Port Site Hernia ◽

One Year

Abstract BackgroundThe incidence of port site hernia (PSH) after laparoscopic surgery can reach up to 4 %. The fascial closure at the port site can be challenging in some cases.MethodsA multi-center, prospective, open label study to evaluate a new integrated port closure system (Gordian TroClose™ 1200 by Gordian Surgical™), is presented.ResultsFifty patients were enrolled in the study. All enrolled patients underwent laparoscopic surgery, during which at least one TroClose1200 device was used per patient. Patients were followed for two and six weeks and for one year. No port PSH related to TroClose 1200 device was diagnosed at one year of follow-up. One PSH was diagnosed at a non-TroClose1200 trocar site. The surgeons were very satisfied with the new device’s performance, with an average range of 4.8-5.0 out of 5.0 usability question being above 4.80 out of 5. No severe adverse events or device related adverse events were observed.ConclusionsThe TroClose 1200 is a simple, safe and friendly device that may reduce the incidence of port site hernia.

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Laparoscopic port closure with a simple, inexpensive, effective and easy procedure to prevent port-site hernia

Current Medicine Research and Practice ◽

10.1016/j.cmrp.2018.12.004 ◽

2019 ◽

Vol 9 (1) ◽

pp. 6-9

Author(s):

Amulya Mohan Acharya

Keyword(s):

Port Site ◽

Laparoscopic Port ◽

Port Closure ◽

Port Site Hernia

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The Lister AirSeal® port closure technique – Initial patient outcomes

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0103 ◽

2019 ◽

Vol 101 (8) ◽

pp. 606-608 ◽

Cited By ~ 1

Author(s):

G Mirmilstein ◽

J Noel ◽

O Gbolahan ◽

N Vasdev ◽

T Lane ◽

...

Keyword(s):

Operating Time ◽

Port Site ◽

Instructional Video ◽

Post Discharge ◽

Pain Scores ◽

Peritoneal Closure ◽

Port Closure ◽

Port Site Hernia ◽

Group 2 ◽

Group 1

Introduction The 12-mm AirSeal® port is widely used in robotically assisted laparoscopic prostatectomy due to its ability to maintain stable pneumoperitoneal pressures and smoke evacuation. However, it creates a potential risk of port site hernia. We have traditionally used EndoClose™ to perform full thickness closure of this port, but noted that patients experienced increased pain related to this procedure, which sometimes persisted for several months. Using the Da Vinci Si we performed peritoneal closure with 2-0 vicryl by switching the fourth arm to the right master controller. The external oblique sheath was closed outside with 1 Ethibond. Materials and methods We performed this closure in 20 consecutive patients (group 1). Postoperative day 1, 2 and post-discharge telephone consultation pain scores (1–10) were recorded and compared with the previous 20 consecutive patients who had the EndoClose closure (group 2). Results We recorded an instructional video to enable reproduction of the new technique. The mean length of stay was 1.5 days for patients in group 1 and 1.9 days for those in group 2 (P = 0.04). There was no difference in operating time or average day 1 pain scores. Post-discharge follow-up call revealed 1 of 20 patients who had AirSeal port site pain in group 1 and 5 of 17 in group 2 (P = 0.04). Pain scores also tended to be higher for group 2. Conclusions Our preliminary analysis of this novel technique to close the AirSeal port in two separate layers improves postoperative pain related to this port site.

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5 mm port site hernia causing small bowel obstruction

Gynecological Surgery ◽

10.1007/s10397-008-0450-6 ◽

2008 ◽

Vol 7 (1) ◽

pp. 71-73 ◽

Cited By ~ 4

Author(s):

Ankur Thapar ◽

Babak Kianifard ◽

Richard Pyper ◽

William Woods

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Port Site ◽

Port Site Hernia

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M512 LAPAROSCOPIC PORT SITE HERNIA

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(12)61700-7 ◽

2012 ◽

Vol 119 ◽

pp. S696-S696

Author(s):

A.M. Nargund ◽

S. Majumdar ◽

I. Stokes

Keyword(s):

Port Site ◽

Laparoscopic Port ◽

Port Site Hernia

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SURGICAL AUDIT - LAPAROSCOPIC CHOLECYSTECTOMY IN A FREE CAMP AT PRIVATE SECTOR HOSPITAL

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i2.405 ◽

2020 ◽

Vol 11 (2) ◽

pp. 16-20

Author(s):

Dr. Abdul Ghani Soomro

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Hospital Stay ◽

Open Cholecystectomy ◽

Port Site ◽

Bladder Injury ◽

Safe Procedure ◽

Trocar Site ◽

Port Site Hernia ◽

Surgical Audit

BACKGROUND & OBJECTIVE: Laparoscopic Cholecystectomy is usual method for the treatment of gall bladder stone disease and is practiced all over the world due to many beneﬁts like fasten the recovery time. Furthermore, it reduced the post-operative pain and period of hospital stay. To conduct Surgical Audit and evaluate safety of Laparoscopic cholecystectomy. METHODOLGY: This prospective study was conducted in a private hospital at Hyderabad during free camps of Laparoscopic Cholecystectomy. Four camps were arranged in 2016 - 2019. Total number of 190 patients underwent Laparoscopic Cholecystectomy during the study period. The patient's age falls between 12–65 years. A detailed history, relevant investigation and Cardiac ﬁtness were evaluated. All patients underwent four ports Lap-Chole. Data was collected assessed and audit was performed and safety was evaluated. RESULTS: Total 190 patients operated females 88.45% and males 11.55%. 115 (60.50%)were in the range of 30-35 years followed by 55 (28.95%)patients in the range of 40-50 years.8 (4.20%) patients were converted to open cholecystectomy, 4 due to bleeding from liver bed, 3 patients due to diﬃcult dissection in calots triangle and 1 due to Empyema of gall bladder.10 patients (5.50%) had Trocar site bleeding, 10 patients (5.50%) had gall bladder injury, in 4 cases had spillage of stones and 72 patients (38.50%) developed umbilical port site infection 1 patient develop port site hernia. No mortality was recorded in this study. CONCLUSION: Our Surgical Audit proves that Laparoscopic Cholecystectomy is a safe procedure on the basis of only 4.2% intra operative and 5.5% postoperative complications and gaining wide spread popularity among our population due to less pain, less hospital stay. We recommend other private hospitals to extent such services to our poor population with symptomatic cholelithiasis.

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