Trocar site post incisional hernia: about 19 cases

It is commonly admitted that laparoscopic surgery has the advantage of abdominal wall preservation. Therefore, having port-site incisional hernia caused by trocars of laparoscopy must be avoided. The aim of this work is to specify predictive factors, therapeutic modalities and to insist on prevention of this avoidable complication. It is a retrospective and descriptive study over a period of 10 years, between January 2006 and December 2015. This series includes 19 consecutive patients who present port-site incisional hernia. Age, initial intervention, site and size of the trocars incisional hernia, diagnostic method, delay and type of the second procedure with the final results were examined and recorded. Our study contains 19 female. The average age was 55 years (29-78). Risk factors were resent in 12 patients. All our patients were operated initially by laparoscopic approach. The average onset time was 6.6 months (3-12). Fourteen patients presented swelling at the trocar site and 5 patients had an emergent surgery due to the strangulation of the port-site incisional hernia. For these five patients a primary suture was made. Hernia content was the great omentum in 11 cases and small bowel in 8 cases. It was umbilical in 16 patients and in the left flank in 3 patients. They occur all where it was placed a 10 mm trocar. The evolution was suitable in all cases. There were two recurrences, one after primary suture and the other after a mesh repair. Port-site incisional hernia is rare. The most incriminated risk factors are essentially trocar size, obesity and open coelioscopy. Vital prognosis can be engaged if port-site incisional hernia is incarcerated or strangulated then prevention is necessary.