INCISIONAL HERNIAS AFTER MAJOR LAPAROSCOPIC GYNECOLOGIC PROCEDURES

OBJECTIVE: Our purpose was to determine the incidence of incisional he rnias after operative laparoscopy. STUDY DESIGN: A retrospective case review was performed. RESULTS: The frequency of incisional hernias at extraumbilical 10 and 12 mm trocar insertion sites was one in 429 (0.2 3%) cases and five in 161 (3.1%) cases, respectively; the difference i s statistically significant (p = 0.007, Fisher's exact test). Incision al hernias were also significantly more common if the fascia was left open (p = 0.021), although three of the five hernias at 12 mm trocar s ites occurred after attempted closure of the underlying fascia. CONCLU SION: The underlying fascia should be closed whenever a 10 mm or large r trocar is placed at an extraumbilical site during laparoscopy. The p eritoneum may also require closure at 12 mm trocar sites if the trocar is placed through, rather than lateral to, the rectus sheath.