MINIMIZING TROCHAR SITE HERNIATION IN LAPAROSCOPIC CHOLECYSTECTOMY

The technique for laparoscopic cholecystectomy (LC) was originally dev ised and described has remained unchanged because of its efficacy.(1) LC involves a 10-mm trochar in periumbilical region, 10-mm trochar in the epigastrium, and two 5-mm trochars at the right anterior axillary line and right midclavicular line. The exposure and dissection provide d by the instruments placed through these trochars is usually adequate and the necessity for additional ports is rare. Our technique modific ation eliminates the epigastric 10-mm port and replaces it with a 5-mm epigastric port and also eliminates one of the lateral 5-mm ports. Re cent articles have reported a significant incidence of Richter's or in cisional hernias at the trochar sites.(2-5) Our modification of the st andard technique has the advantage of eliminating a potential incision al hernia at the epigastric port site and further improvement of cosme tic result.