Port-site hernia following laparoscopic cholecystectomy
Open accessAbstract
BACKGROUND: Port-site hernia is a rare but potentially serious complication of laparoscopic cholecystectomy. This study aimed to review the current literature, assess the incidence and causes of port-site hernias, and identify methods to reduce the risk. METHODS: A systematic search of the literature published in English from 1995 to 2010 was conducted using PubMed to identify all reports of port-site, trocar-site, or incisional hernia following laparoscopic cholecystectomy. Studies in over 100 patients were identified before the application of defined exclusion criteria. The incidence of port-site hernia was calculated and compared with historical data. Predisposing factors were reviewed. RESULTS: Seven studies met the search criteria, with 99 port-site hernias in 5984 patients. The overall incidence of port-site hernia was 1.7% (range, 0.3% to 5.4). The most important factors were older age, higher body mass index, preexisting hernia, trocar design, trocar diameter, increased duration of surgery, and extension of the port site for gallbladder extraction. CONCLUSION: The incidence of port-site hernia is low but likely to be underestimated and has not declined over time. Awareness of the predisposing factors and modification of techniques may help to reduce the risk.
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The umbilical port is most frequently associated with port-site hernia, followed by the epigastrium and the left and right hypochondrium.
“The umbilical port was most frequently associated with port-site hernia (PSH), followed by the epigastrium and the left and right hypochondrium.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Prolonged port manipulation and reinsertion are responsible for the development of port-site hernia.
“Prolonged port manipulation and reinsertion, longer surgical times, failure to effectively close the fascial defect, and wound infection are responsible for the development of PSH.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Failure to effectively close the fascial defect is responsible for the development of port-site hernia.
“Prolonged port manipulation and reinsertion, longer surgical times, failure to effectively close the fascial defect, and wound infection are responsible for the development of PSH.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Wound infection is responsible for the development of port-site hernia.
“Prolonged port manipulation and reinsertion, longer surgical times, failure to effectively close the fascial defect, and wound infection are responsible for the development of PSH.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Longer surgical times are responsible for the development of port-site hernia.
“Prolonged port manipulation and reinsertion, longer surgical times, failure to effectively close the fascial defect, and wound infection are responsible for the development of PSH.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Port-site hernia can cause serious side effects such as intestinal blockage, strangling, and perforation, in addition to pain.
“PSH can cause serious side effects such as intestinal blockage, strangling, and perforation, in addition to pain [4].”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Port-site hernia incidences range from 0.14% to 22% in a variety of laparoscopic operations.
“There have been reports of PSH incidences ranging from 0.14% to 22% in a variety of laparoscopic operations.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Advanced age, greater BMI, a prior hernia, trocar diameter and design, longer surgical duration, and extension of the gallbladder extraction port site are the most significant variables for port-site hernia.
“The most significant variables included advanced age, greater BMI, a prior hernia, trocar diameter and design, longer surgical duration, and an extension of the gallbladder extraction port site.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
The overall frequency of port-site hernias following laparoscopic cholecystectomy is 1.7% (range 0.3% to 5.4).
“1.7% was the overall frequency of port-site hernias (range: 0.3% to 5.4).”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
Hernias have been associated with diabetes mellitus, acquired immune deficiency syndrome, renal failure, and chronic obstructive pulmonary disease.
“Hernias have been associated with several medical conditions, such as diabetes mellitus, acquired immune deficiency syndrome, renal failure, and chronic obstructive pulmonary disease.”
From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [4]
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References 47 · Cited by 130
- Authors
- Bunting, D. M.
- Affiliations
- North Devon District Hospital (GB)
- Corresponding author
- Bunting, David Mark
- ORCID
- Bunting, David Mark
- Venue
- JSLS : Journal of the Society of Laparoendoscopic Surgeons
- Published
- 2010
- Volume
- 14
- Issue
- 4
- Pages
- 490-497
- ISSN
- 1086-8089 (ISSN-L)
- 1938-3797
- PMC
- PMC3083037
- OpenAlex
- W1975691881
- Cited by
- 130
- References
- 47
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 8 · 2020: 6 · 2019: 9 · 2018: 13 · 2017: 11 · 2016: 15 · 2015: 10 · 2014: 6 · 2013: 9 · 2012: 7
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- JSLS Journal of the Society of Laparoscopic & Robotic Surgeons (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
- Keywords
- port site hernia, laparoscopic cholecystectomy, postoperative complications, trocar design, risk factors, incidence, body mass index, surgical technique modification
- MeSH terms
- Germany, Humans, Postoperative Complications, Incidence, Cholecystectomy, Laparoscopic, Hernia, Abdominal
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