Trocar site hernias from using bladeless trocars: should fascial closure be performed?

Laparoscopic surgery is the modality of choice in the surgical treatment of colorectal malignancies. The reported incidence of trocar site hernias is 0.65–2.80% with conventional cutting-tip trocars, and this risk increases with the diameter of the trocar. Newer bladeless, blunt-tipped trocars effectively mitigate this risk, and routine fascial closure has been generally deemed unnecessary. We present two cases of trocar site hernias despite the use of bladeless trocars in laparoscopic colorectal surgery, challenging the conventional wisdom of leaving such fascial defects open.