N. Kadar et al., INCISIONAL HERNIAS AFTER MAJOR LAPAROSCOPIC GYNECOLOGIC PROCEDURES, American journal of obstetrics and gynecology, 168(5), 1993, pp. 1493-1495
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.