ABDOMINAL-WALL METASTASES FOLLOWING LAPAROSCOPY

Only 18 cases of recurrence at the sites of cannula insertion after la paroscopy have been reported in the literature, ten of them in the pas t year. The period between laparoscopic surgery and presentation of wo und metastasis varies widely, from 7 days to 10 months; the lesions ar e typically hard, craggy and painful. The most likely mechanism is dir ect implantation of viable exfoliated tumour cells but three aspects s pecific to laparoscopy may also be important. First, there may be incr eased exfoliation of tumour cells following manipulation by laparoscop ic instruments of an unsuspected malignancy. Second, there may be repe ated close contact between tumour-laden instruments and the port. Thir d, the passage of resected tissue through a small incision may coat th e wound with potentially malignant cells.