Page 28 - WJOLS - Surgery Journal

Trocar Site Hernia
Stretching the Port Site for Retrieval Following were the predisposing factors affecting the
trocar site hernia:
Enlargement of umbilical wound for retrieving this specimen 1. Trocar size: Bigger the size of trocar more the chance of

may be the cause of trocar site hernia. It is certain that forced trocar site hernia.
dilation of fascial layer is considered to be cause for herniation. 2. Closing trocar site/leaving open: Hernia was reported more
when the trocar site was left open.
Effects of CO
2 3. Open/closed laparoscopy: Open method by Hasson’s trocar
CO may push the omentum/intestine through the insertion has shown less chance of trocar site hernia when compare
2
point in the fascia. These structures of may be trapped by to closed method by Veress needle, by Mayol, et al. 22
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abdominal contractions. 6,8 Duoron et al stated said that partial 4. Location: Most hernia appeared at midline trocar and
vacuum is created with the withdrawal of port, thus drawing umbilical sites were found to be commonest.
intestine/omentum in the fascial defect. 5. Stretching portsite for retrieval of tissue was another cause
for trocar site hernia.
Host Problem 6. Effect of compressed CO .
2
7. Obesity and nutrition.
4,7
Azurin et al, stated that trocar site hernia occur in patient with 8. Infection of port site was the important predisposing factor
comorbidity as wound infection, obesity, diabetics mellitus, for development of trocar site hernia.
although these did not reach statistical significance with
obesity and nutrition was also one of the factor of trocar site CONCLUSION
hernia.
In this review article, classification of trocar site hernia was done
Infection by various study reports. We believe that a more clinical accurate
identification is available from this classification. This may be
Port site infection is the predisposing factor for the development useful for preventing complications in laparoscopy surgery if
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of the hernia. Callery et al, reported that often umbilical insertion the surgeon is aware of the correlation between the types of
gets infected. Late onset hernia may be related to infection from trocar site hernia and clinical manifestation before the surgery.
stab wound.
REFERENCES
DISCUSSION
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1993;3:567-70.
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3. Special type indicates whole abdominal wall dehiscence, Gopegui M, Pastor-Sirera L, Tamames-Escobar S. Incisional
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Fear in which a loop of bowel herniated through the defect 9. Maio A, Ruchman RB. CT diagnosis of post laparoscopic hernia.
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