Published in:
01-12-2020 | Laparoscopy | Original Scientific Report
Port Site Hernias Following Laparoscopic Ventral Hernia Repair
Published in: World Journal of Surgery | Issue 12/2020
Login to get accessAbstract
Background
Port site hernias (PSH) are underreported following laparoscopic ventral hernia repair (LVHR). Most occur at the site of laterally placed 10–12-mm ports used to introduce large pieces of mesh. One alternative is to place the large port through the ventral hernia defect; however, there is potential for increased risk of surgical site infection (SSI). This study evaluates the outcomes when introducing mesh through a 10–12-mm port placed through the hernia defect.
Methods
This was a retrospective case series of patients who underwent LVHR in three prospective trials from 2014–2017 at one institution. All patients had mesh introduced through a 10–12-mm port placed through the ventral hernia defect. The primary outcome was SSI. Secondary outcomes were hernia occurrences including recurrences and PSH.
Results
A total of 315 eligible patients underwent LVHR with a median (range) follow-up of 21 (11–41) months. Many patients were obese (66.9%), recently quit tobacco use (8.8%), or had diabetes (18.9%). Most patients had an incisional hernia (61.2%), and 19.2% were recurrent. Hernias were on average 4.8 ± 3.8 cm in width. Two patients (0.6%) had an SSI. Fourteen patients had a hernia occurrence—13 (4.4%) had a recurrent hernia, and one patient (0.3%) had a PSH.
Conclusion
During LVHR, introduction of mesh through a 10–12-mm port placed through the hernia defect is associated with a low risk of SSI and low risk of hernia occurrence. While further studies are needed to confirm these results, mesh can be safely introduced through a port through the defect.