Trocar site hernia
Abstract
OBJECTIVE: To review the relationship between the pathogenesis and clinical manifestations of trocar site hernias seeking to confirm the definition of trocar site hernias by classification. DATA SOURCES: We searched this subject in English on MEDLINE by combining the words "trocar," "port," "hernia, and "laparoscopy."Data Extraction and STUDY SELECTION: We limited the main operations to cholecystectomy, colon and rectal surgery, fundoplication, and gastric surgery; finding 44 reports on these procedures. Of these, 19 were case reports, 18 were original articles (setting criteria; the incidence of the trocar site hernia was clarified, and involved >100 patients), and 7 technical notes on "how to do it" were collected. We obtained 19 additional reports using the references of those previously obtained. We, thus, reviewed 63 reports (24 case reports, 27 original articles, 7 technical notes, and 5 review articles). DATA SYNTHESIS: Trocar site hernia was classified into 3 types. The early-onset type that occurred immediately after the operation, with a small-bowel obstruction, especially the Richter hernia, frequently developing. The late-onset type that occurred several months after the operation, mostly with local abdominal bulging with no small-bowel obstruction developing. The special type that occurred indicated the protrusion of the intestine and/or omentum. Trocar site hernias with fascial defects of 10 mm or larger should be closed, including the peritoneum. Opinion varied if a 5-mm trocar site defect should be closed. CONCLUSION: It is useful to clearly classify trocar site hernias to improve management of laparoscopic procedures.
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Port-site hernia has been classified into three types: early, late, and special.
“Though it has not been generally adopted, PSH has been classified into three types: early (dehiscence of fascial planes and peritoneum), late (dehiscence of the fascial plane with intact peritoneal hernia sac), and special (dehiscence of the entire abdominal wall) [30].”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [30]
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“Though it has not been generally adopted, PSH has been classified into three types: early (dehiscence of fascial planes and peritoneum), late (dehiscence of the fascial plane with intact peritoneal hernia sac), and special (dehiscence of the entire abdominal wall) [30].”
BackgroundMethod
- Authors
- Tonouchi, H.
- Affiliations
- Mie University (JP)
- Corresponding author
- Tonouchi, Hitoshi
- Venue
- Archives of Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2004-11-01
- Volume
- 139
- Issue
- 11
- Pages
- 1248
- ISSN
- 0004-0010 (ISSN-L)
- OpenAlex
- W2046305316
- Cited by
- 435
- References
- 70
- Citations by year
- 2026: 13 · 2025: 20 · 2024: 21 · 2023: 20 · 2022: 22 · 2021: 16 · 2020: 27 · 2019: 18 · 2018: 22 · 2017: 18 · 2016: 19 · 2015: 20 · 2014: 28 · 2013: 36 · 2012: 23
- FWCI
- 7.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- trocar site hernia, laparoscopic surgery complications, Richter hernia, small bowel obstruction, hernia classification, fascial defect closure, cholecystectomy, colon and rectal surgery, fundoplication, gastric surgery, omental herniation
- MeSH terms
- Hernia, Humans, Laparoscopy, Digestive System Surgical Procedures, Surgical Instruments, Incidence
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