Trocar-Site Hernia After Single-Port Cholecystectomy: Not an Exceptional Complication?

Krajinovic, Katica; Ickrath, Pascal; Germer, Christoph-Thomas; Reibetanz, Joachim
December 2011
Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2011, Vol. 21 Issue 10, p919
Academic Journal
Background: When compared with standard multiport laparoscopy, the larger fascial incision in single-port surgery (SPS) may imply a potentially increased risk of surgical-site complications, such as herniation. The long-term risk of access-site complications in SPS is still unpredictable. Methods: Between July 2009 and May 2011, n=78 patients ( n=54 females), with a median age of 42 years (range: 18-85 years), underwent single-port cholecystectomy. The median body mass index was 25.4 kg/m2 (range: 17-39 kg/m2). All surgeries were performed by a single surgeon (K.K.) using a completely reusable single-port access device (X-Coneâ„¢; KARL STORZ GmbH, Tuttlingen, Germany), and fascial closure technique was comparable in all patients. The first 50 patients ( n=32 females) attended a structured follow-up examination including a meticulous clinical examination and ultrasonography of the access site at a median follow-up time of 17 months (range: 9-23 months). Results: We recorded postoperative complications in 5 of the 50 patients (10%) after single-port cholecystectomy. Four occurred in the early postoperative course and presented as mild wound complications. One of the 50 patients (2%) experienced a symptomatic trocar-site hernia (TSH) 4 months after surgery. No biliary complications (bile leakage, retained stones, etc.) were recorded. Conclusions: Although potentially biased by a relatively small number of patients, our study provides evidence that TSH after single-port cholecystectomy is (i) not less frequent when compared with standard laparoscopy, (ii) not as infrequent as suggested by the current literature, and (iii) not only associated with technical failure or patients' comorbidity.


Related Articles

  • Trocar Site Hernia- A Case Series. Sharma, Mriganka; Kumar, Sunil; Agarwal, Nitin // Indian Journal of Surgery;Apr2012, Vol. 74 Issue 2, p189 

    The article presents a series of case studies relating to trocar site hernias (TSH), a rare but potentially dangerous complication of laparoscopic surgery. It presents a case of a 44 year old multipara female who underwent interval laparoscopic cholecystectomy for calculous cholecystitis and of...

  • Inguinal hernia repair in a community setting: implications for the elderly. Rogers, F. B.; Guzman, E. A. // Hernia;Feb2011, Vol. 15 Issue 1, p37 

    Objective: Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity. Design: Case series. Retrospective review of a prospectively collected database. Setting: Single...

  • Percutaneous cholecystostomy in the management of acute calculous cholecystitis. Markakis, C.; Moschouris, H.; Grivas, P.; Voultsos, M.; Dikeakos, P.; Marinis, A.; Rizos, S. // Scientific Chronicles / Epistimonika Chronika;Jan2013, p29 

    Background- Aim: Percutaneous cholecystostomy is a minimally invasive technique for the management of acute cholecystitis. In this study we present a series of patients with acute calculous cholecystitis treated with percutaneous cholecystostomy. Patients- Methods: The characteristics of...

  • Clinical predictors of operative complexity in laparoscopic ventral hernia repair: a prospective study. Jenkins, Eric D.; Yom, Victoria H.; Melman, Lora; Pierce, Richard A.; Schuessler, Richard B.; Frisella, Margaret M.; Eagon, J. Christopher; Brunt, L. Michael; Matthews, Brent D. // Surgical Endoscopy;Aug2010, Vol. 24 Issue 8, p1872 

    Because of uncertainties about the complexity of laparoscopic ventral hernia repair for varying patient populations, surgeons may be reluctant to perform this procedure. This study aimed to delineate the risk factors that can be identified in the preoperative setting predictive of longer...

  • Minimal incision transinguinal repair for incarcerated obturator hernia. Togawa, Y.; Muronoi, T.; Kawaguchi, H.; Chiku, T.; Sano, W.; Hashiba, T.; Ueda, A.; Kaneoya, K. // Hernia;Jun2014, Vol. 18 Issue 3, p407 

    Background: Patients with incarcerated obturator hernia are usually elderly, frail, and physically inactive women with serious comorbidities. Although a laparotomy is standard surgical intervention for emergency incarcerated or strangulated obturator hernia, it is invasive particularly for these...

  • Comparison between the short-term results of onlay and sublay mesh placement in the management of uncomplicated para-umbilical hernia: a prospective randomized study. Bessa, S.; El-Gendi, A.; Ghazal, A.-H.; Al-Fayoumi, T. // Hernia;Feb2015, Vol. 19 Issue 1, p141 

    Purpose: The aim of this study was to compare between the short-term results of onlay and sublay mesh placement in the prosthetic repair of uncomplicated para-umbilical hernia (PUH). Methods: Eighty patients with a defect size ranging from 4 to 10 cm were prospectively randomized to either the...

  • Complex Post-cholecystectomy Biliary Injuries: Management with 10 Years' Experience in a Major Referral Center. Redwan, Alaa Ahmed // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2012, Vol. 22 Issue 6, p539 

    Purpose: A prospective and retrospective work to evaluate management of post-cholecystectomy biliary injuries. Patients and Methods: From March 2000 to February 2010, 419 patients (224 females and 195 males) complaining of post-cholecystectomy biliary injuries were managed using surgery in 135...

  • Looking beyond age and co-morbidities as predictors of outcomes in paraesophageal hernia repair. Gupta, Anirban; Chang, David; Steele, Kimberley E.; Schweitzer, Michael A.; Lyn-Sue, Jerome; Lidor, Anne O. // Journal of Gastrointestinal Surgery;Dec2008, Vol. 12 Issue 12, p2119 

    Introduction: Paraesophageal hernia (PEH) repair is a technically challenging operation. These patients are typically older and have more co-morbidities than patients undergoing anti-reflux operations for gastroesophageal reflux disease (GERD), and these factors are usually cited as...

  • CURA CHIRURGICALÄ‚ PE CALE LAPAROSCOPICÄ‚ A EVENTRAÈšIILOR POSTOPERATORII - ANALIZA PRIMELOR CAZURI -. Pusel, Iustina Gabriela; Veselu, G.; Păduraru, M. // Jurnalul de Chirurgie;2013, Vol. 9 Issue 3, p249 

    Laparoscopic repair of incisional hernias is associated with low rate of postoperative pain and morbidity. However the choices of the mesh and fixation methods are crucial issues in preventing complications and recurrence. We present herein the initial experience using lightweight polypropylene...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics