Page 10 - Laparoscopic Journal - WJOLS
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Balamurali Krishna Kotakala, RK Mishra
          to evaluate the safety, efficacy and cost-effectiveness of     5.  Romagnolo C, Minelli L. Small-bowel occlusion after opera-
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                                                                  Endoscopy 2001;33:88-90.
             One of the preventable complications is port-site      6.  Yamamoto M, Minikel L, Zaritsky E. Laparoscopic 5 mm tro-
          incisional hernias (PIHs), which could develop at any   car site herniation and literature review. J Soc Laparoendosc
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          of the absence of supporting muscle. The incidence of     7.  Azurin DJ, Go LS, Arroyo LR, Kirkland ML. Trocar site
          PIH is variable from center to center, depending on     herniation following laparoscopic cholecystectomy and the
                                                                  significance of an incidental pre-existing umbilical hernia.
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          course, surgical experience.                          8.  Uslu HY, et al. Trocar site hernia after laparoscopic cholecys-
             The trocar diameter, trocar design, pre-existing     tectomy. J Laparoendosc Adv Surg Tech A 2007;17:600-603.
          fascial defects, and some operation and patient-related     9.  Shalhav AL, et al. Transperitoneal laparoscopic renal surgery
          factors, direction of the port insertion, use of a drain, and   using blunt 12 mm trocar without fascial closure. J Endourol
                                                                  Soc 2002;16:43-46.
          the site of the port are the risk factors for development     10.  Skipworth JRA, Khan Y, Motson RW, Arulampalam TH,
                20
          of PIH.  In obese and bariatric patients because of the   Engledow AH. Incisional hernia rates following laparoscopic
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          pressure, the risk of formation of trocar-site hernia is     11.  Parker HH 3rd, Nottingham JM, Bynoe RP, Yost MJ. Lapa-
                 21
          greater.  Size of the port is another major risk factor,   roscopic repair of large incisional hernias. Am Surg 2002;68:
                                                                  530-533.
          and some authors advise closure of holes > 5 mm at the     12.  Bowrey DJ, et al. Risk factors and the prevalence of trocar site
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          up was done and there has been no incidences of port-site     14.  Hussain A, et al. Long-term study of port-site incisional
          hernia.                                                 hernia after laparoscopic procedures. J Soc Laparoendosc
                                                                  Surg 2009;13:346-349.
          CoNCLuSioN                                            15.  Crist DW, Gadacz TR. Complications of laparoscopic surgery.
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          The meticulous closure of laparoscopic ports is important     16.  Shaher Z. Port closure techniques. Surg Endosc 2007;21:
          to prevent and reduce the chances of formation of port-  1264-1274.
          site incisional hernia. Port-site closure by Veress needle     17.  Lasheen AE, Elzeftawy A, Ahmed AHM, Lotfy WE. Ana-
          is an efficient and safe technique done under vision and   tomical closure of trocar site by using tip hole needle and
                                                                  redirecting suture hook. Surg Endosc 2010;24:2637-2639.
          there is no need to buy additional equipment to close the     18.  Su WH, et al. Port wound closure assisted by Foley catheter:
          port-site, thus cost-effective.                         an easier way to provide fascia security. J Obstet Gynaecol
                                                                  Res 2009;35:725-731.
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