Page 48 - Journal of Laparoscopic Surgery

Mohammed Arifuzaman, Asna Samreen
• It would be advisable to view the abdominal side of 3. Walker Reynolds J. The first laparoscopic cholecystectomy.
each wound, wherever possible, during fascial closure JSLS: Journal of the Society of Laparoendoscopic Surgeons.
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• Use of excessive torque or levering must be avoided 4. Sain AH. Laparoscopic cholecystectomy is the current” gold
standard” for the treatment of gallstone disease. Annals of
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• Trocar insertion in an oblique fashion or a Z-tract may 5. Eden CG, King D, Kooiman GG, Adams TH, Sullivan ME,
reduce hernia formation by putting the external and Vass JA. Transperitoneal or extraperitoneal laparoscopic
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internal defects at different levels. radical prostatectomy: does the approach matter? J Urol 2004;
• Percutaneous surgical system use in place of a stan- 172: 2218-2223.
dard port is advisable if the port is being used only 6. Bemelman WA, Dunker MS, Busch ORC, Den Boer KT, De Wit
LTH, Gouma DJ. Efficacy of establishment of pneumoperito-
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for minimal instrumentation. neum with the Veress needle, Hasson trocar, and modified
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• Use the smallest diameter ports necessary. blunt trocar (TrocDoc): a randomized study. J Laparoendosc
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This can also be seen during specimen removal. 62,66 adhesion formation. Human reproduction update. 2001 Nov
• Ideally, the 5 mm ports must be removed under the 1;7(6):547-555.
vision of the laparoscope to prevent the chimney 9. Elkins TE. A histological evaluation of peritoneal injury and
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unrecognized or preexisting hernial defects that may 12. Phillips EH, Arregui M, Carroll BJ, Corbitt J, Crafton WB,
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hernias necessitates enlarging the incision and per- 13. Swank HA, Mulder IM, La Chapelle CF, Reitsma JB, Lange
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14. Bensley RP, Schermerhorn ML, Hurks R, Sachs T, Boyd CA,
CONCLUSION O’Malley AJ, Cotterill P, Landon BE. Risk of late-onset adhe-
sions and incisional hernia repairs after surgery. Journal of
Port closure is one of the most pertinent steps of a minimal the American College of Surgeons. 2013 Jun 1;216(6):1159-167.
access surgery and closure has to be achieved in all the 15. Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M. Trocar
ports which are 10 mm or greater. Care must be taken to site hernia. Arch Surg. 2004 Nov; 139(11):1248-1256.
inspect the 5 mm ports and closure achieved in case where 16. Shaher Z. Port closure techniques. Surg Endosc. 2007
Aug;21(8):1264-1274. Epub 2007 Feb 7.
excessive leverage or torque has come into play. Any of the 17. Kamer E, Unalp HR, Derici H, Tansug T, Onal MA. Laparo-
abovementioned port closure methods may be utilized. scopic cholecystectomy accompanied by simultaneous
The ideal technique in the view of the authors are those that umbilical hernia repair: A retrospective study. J Postgrad
are inexpensive, require minimal additional instruments, Med 2007;53:176-180.
require minimum skill, are easy to learn, can produce 18. Botea F, Torzilli G, Sarbu V. A simple, effective technique
reproducible results and most importantly, must produce for port-site closure after laparoscopy. JSLS: Journal of the
Society of Laparoendoscopic Surgeons. 2011 Jan;15(1):77.
minimal to no port site hernia. The classical suture passer, 19. Lasheen A, Safwat K, Fiad A, Elmoregy A, Hamed AW. Port-
veress needle or their basic modifications might come close site closure using a modified aptos needle. JSLS: Journal of the
to the ideal port closure technique. Society of Laparoendoscopic Surgeons. 2013 Apr;17(2):312-
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