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Cited by 48Hernia repair and managementMinimally Invasive Surgical TechniquesAbdominal Surgery and Complications

Port-site incisional hernia: a case series of 54 patients

Open access
Lambertz, A., Stüben, B. O., Bock, B., Eickhoff, R., Kroh, A., Klink, C. D., Neumann, U. P., Krones, C. J.·2017·Annals of Medicine & Surgery
DOI 10.1016/j.amsu.2017.01.001PMC PMC5237772
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Abstract

The increased use of laparoscopy has resulted in certain complications specifically associated with the laparoscopic approach, such as port-site incisional hernia (PIH). Until today, it is not finally clarified if port-site closure should be performed by fascia suture or not. Furthermore, the optimal treatment strategy in PIH (suture vs. mesh) is still widely unclear. The aim of this study was to present our experience with PIH in two independent departments and to derive possible treatment strategies from these results. Between 2003 and 2013, 54 patients were operated due to port-site incisional hernia in two surgical centres. Their data were collected and retrospectively analyzed depending on surgical technique of port-site hernia repair (Mesh repair group, n = 13 vs. Suture only group, n = 41). Port site incisional hernia occurred in 96% (52 patients) after the use of trocars with 10 mm or larger diameter. Patients treated with mesh repair had significantly higher body mass index (BMI) (32 ± 9 vs. 27 ± 4; p = 0.023) and significantly higher rates of cardiac diseases (77% vs. 39%; p = 0.026) than patients in the suture only group. Mean fascial defect size was significantly larger in the Mesh repair group than in the Suture only group (31 ± 24 mm vs. 24 ± 32 mm; p = 0.007) and mean time of operation was significantly longer in patients operated with mesh repair (83 ± 47 min vs. 40 ± 28 min; p < 0.001). There were no significant differences in mean hospital stay (3 ± 4 days; p = 0.057) and hernia recurrence rates (9%; p = 0.653) between study groups. Mean time of follow up was 32 ± 35 months. In Port sites of 10 mm and larger diameter fascia should be closed by suture, whereas the risk of hernia development in 5 mm trocar placements seems to be a rare complication. Port-site incisional hernia should be treated by suture or mesh repair depending on fascial defect size and the patients' risk factors regarding preexisting deseases and body mass index.

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  • In Lambertz et al., there were no significant changes in mean hospital stay or hernia recurrence rate between the study groups.

    “Between the study groups, there were no significant changes in the mean hospital stay (3 ± 4 days; p=0.057) or the hernia recurrence rate (9%; p=0.653) [9].”

    From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [9]

  • 96% of patients experienced a port-site incisional hernia following the application of trocars with a diameter of 10 mm or more.

    “96% of patients experienced a port-site incisional hernia following the application of trocars with a diameter of 10 mm or more.”

    From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [9]

  • In Lambertz et al., the mesh repair group had significantly higher BMI and significantly higher rates of heart illnesses compared to the suture-only group.

    “Compared to patients in the suture-only group, individuals treated with mesh repair had considerably higher BMI and significantly higher rates of heart illnesses.”

    From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [9]

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Authors
Lambertz, A., Stüben, B. O., Bock, B., Eickhoff, R., Kroh, A., Klink, C. D., Neumann, U. P., & Krones, C. J.
Affiliations
Universitätsklinikum Aachen (DE)
Corresponding author
Lambertz, A.
ORCID
Venue
Annals of Medicine & Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-02
Volume
14
Pages
8-11
ISSN
2049-0801 (ISSN-L)
DOI
10.1016/j.amsu.2017.01.001
PMC
PMC5237772
OpenAlex
W2569366632
Cited by
48
References
29
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 2
FWCI
4.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of Medicine and Surgery (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • RWTH Publications (RWTH Aachen) (submittedVersion, cc-by-nc-nd)
  • Research Publications (Maastricht University) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
  • RWTH Publications (RWTH Aachen)
Topics
  • Health Sciences › Medicine › Surgery › Hernia repair and management
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
Keywords
laparoscopic surgery complications, port site closure, mesh repair, hernia recurrence, body mass index, cardiovascular comorbidity, hernia repair

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