Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy

Non-bladed trocars and radially dilating systems are considered less traumatic to the abdominal wall because they do not incise the fascia itself. Since the fascia is not cut, it has believed that the fascia closes by itself. Consequently, several authors have suggested that closure of the abdominal...

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Main Authors: Erik J. Kouba, J. Slade Hubbard, Eric Wallen, Raj S. Pruthi
Format: Article
Language:English
Published: Wiley 2006-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/tsw.2006.372
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author Erik J. Kouba
J. Slade Hubbard
Eric Wallen
Raj S. Pruthi
author_facet Erik J. Kouba
J. Slade Hubbard
Eric Wallen
Raj S. Pruthi
author_sort Erik J. Kouba
collection DOAJ
description Non-bladed trocars and radially dilating systems are considered less traumatic to the abdominal wall because they do not incise the fascia itself. Since the fascia is not cut, it has believed that the fascia closes by itself. Consequently, several authors have suggested that closure of the abdominal fascia may be unnecessary when such non-bladed laparoscopic trocars are used. We report of a case in which a port site hernia was diagnosed at the site of a 12 mm non-bladed trocar 11 days after laparoscopic nephrectomy. Although it may be true that in many cases port site closure is unnecessary and does not result in bowel herniation, this case along with a prior report serve as important reminders that port site hernias are possible even in the use of non-bladed or radial dilating systems, and that there exists a number of potential variables that may predispose to herniation and consequently the ability to predict such events in individual patients remains uncertain. As such, we recommend closing 10 mm or larger port sites irrespective of trocar design.
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spelling doaj-art-3d2ed8051e834faa9341b02d00f345282025-02-03T01:20:57ZengWileyThe Scientific World Journal1537-744X2006-01-0162399240210.1100/tsw.2006.372Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic NephrectomyErik J. Kouba0J. Slade Hubbard1Eric Wallen2Raj S. Pruthi3Division of Urologic Surgery, The University of North Carolina at Chapel Hill, NC, USADivision of Urologic Surgery, The University of North Carolina at Chapel Hill, NC, USADivision of Urologic Surgery, The University of North Carolina at Chapel Hill, NC, USADivision of Urologic Surgery, The University of North Carolina at Chapel Hill, NC, USANon-bladed trocars and radially dilating systems are considered less traumatic to the abdominal wall because they do not incise the fascia itself. Since the fascia is not cut, it has believed that the fascia closes by itself. Consequently, several authors have suggested that closure of the abdominal fascia may be unnecessary when such non-bladed laparoscopic trocars are used. We report of a case in which a port site hernia was diagnosed at the site of a 12 mm non-bladed trocar 11 days after laparoscopic nephrectomy. Although it may be true that in many cases port site closure is unnecessary and does not result in bowel herniation, this case along with a prior report serve as important reminders that port site hernias are possible even in the use of non-bladed or radial dilating systems, and that there exists a number of potential variables that may predispose to herniation and consequently the ability to predict such events in individual patients remains uncertain. As such, we recommend closing 10 mm or larger port sites irrespective of trocar design.http://dx.doi.org/10.1100/tsw.2006.372
spellingShingle Erik J. Kouba
J. Slade Hubbard
Eric Wallen
Raj S. Pruthi
Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
The Scientific World Journal
title Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
title_full Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
title_fullStr Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
title_full_unstemmed Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
title_short Incisional Hernia in a 12-mm Nonbladed Trocar Site Following Laparoscopic Nephrectomy
title_sort incisional hernia in a 12 mm nonbladed trocar site following laparoscopic nephrectomy
url http://dx.doi.org/10.1100/tsw.2006.372
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AT ericwallen incisionalherniaina12mmnonbladedtrocarsitefollowinglaparoscopicnephrectomy
AT rajspruthi incisionalherniaina12mmnonbladedtrocarsitefollowinglaparoscopicnephrectomy