Is fascial closure required for a 12-mm trocar? A comparative study on trocar site hernia with long-term follow up
Issued Date
2023-01-16
Resource Type
eISSN
23078960
Scopus ID
2-s2.0-85146676908
Journal Title
World Journal of Clinical Cases
Volume
11
Issue
2
Start Page
357
End Page
365
Rights Holder(s)
SCOPUS
Bibliographic Citation
World Journal of Clinical Cases Vol.11 No.2 (2023) , 357-365
Suggested Citation
Krittiyanitsakun S., Nampoolsuksan C., Tawantanakorn T., Suwatthanarak T., Srisuworanan N., Taweerutchana V., Parakonthunv T., Phalanusitthepha C., Swangsri J., Akaraviputh T., Methasate A., Chinswangwatanakul V., Trakarnsanga A. Is fascial closure required for a 12-mm trocar? A comparative study on trocar site hernia with long-term follow up. World Journal of Clinical Cases Vol.11 No.2 (2023) , 357-365. 365. doi:10.12998/wjcc.v11.i2.357 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82695
Title
Is fascial closure required for a 12-mm trocar? A comparative study on trocar site hernia with long-term follow up
Author's Affiliation
Other Contributor(s)
Abstract
BACKGROUND Despite the infrequency of trocar site hernias (TSHs), fascial closure continues to be recommended for their prevention when using a ≥ 10-mm trocar. AIM To identify the necessity of fascial closure for a 12-mm nonbladed trocar incision in minimally invasive colorectal surgeries. METHODS Between July 2010 and December 2018, all patients who underwent minimally invasive colorectal surgery at the Minimally Invasive Surgery Unit of Siriraj Hospital were retrospectively reviewed. All patients underwent cross-sectional imaging for TSH assessment. Clinicopathological characteristics were recorded. Incidence rates of TSH and postoperative results were analyzed. RESULTS Of the 254 patients included, 70 (111 ports) were in the fascial closure (closed) group and 184 (279 ports) were in the nonfascial closure (open) group. The median follow up duration was 43 mo. During follow up, three patients in the open group developed TSHs, whereas none in the closed group developed the condition (1.1% vs 0%, P = 0.561). All TSHs occurred in the right lower abdomen. Patients whose drains were placed through the same incision had higher rates of TSHs compared with those without the drain. The open group had a significantly shorter operative time and lower blood loss than the closed group. CONCLUSION Routine performance of fascial closure when using a 12-mm nonbladed trocar may not be needed. However, further prospective studies with cross-sectional imaging follow-up and larger sample size are needed to confirm this finding