metricas
covid
Buscar en
Cirugía Española (English Edition)
Toda la web
Inicio Cirugía Española (English Edition) Trocar site incisional hernia in laparoscopic surgery
Información de la revista
Vol. 89. Núm. 2.
Páginas 72-76 (febrero 2011)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 89. Núm. 2.
Páginas 72-76 (febrero 2011)
Review article
Acceso a texto completo
Trocar site incisional hernia in laparoscopic surgery
Eventración de los orificios de los trocares en cirugía laparoscópica
Visitas
2257
Jordi Comajuncosas
Autor para correspondencia
jordi.comajuncosas@pssjd.org

Corresponding author.
, Helena Vallverdú, Rolando Orbeal, David Parés
Servicio de Cirugía General y Digestiva, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Este artículo ha recibido
Información del artículo
Abstract

Trocar site incisional hernias (TSIH) are the most common complications in laparoscopic surgery. We have carried out a review of the literature with the aim of establishing their incidence, the reasons for them happening, and their prevention.

After a search in the MEDLINE PubMed and PubMed CENTRAL data bases from 1991 to 2009, combining the words: “hernia”, “laparoscopy” and “trocar”, we obtained 545 articles, of which we analysed 60 of them.

The incidence of TSIH varies between 0.18% and 2.8%.

The diameter of the trocar, obesity and age play a fundamental role when proceeding to close the fascia, a closure which is the most important factor to prevent these incisional hernias appearing.

The appearance of new laparoscopic material and the increasing more common closure of defects of the fascia means that new and more extensive prospective studies should be performed.

Keywords:
Trocar site incisional hernia
Hernia
Laparoscopy
Resumen

La eventración de los orificios de los trocares (EOT) es la más frecuente complicación de la cirugía laparoscópica. Hemos realizado una revisión de la literatura con el fin de establecer su incidencia, las causas de aparición de las mismas y su prevención.

Tras una búsqueda en las bases de datos MEDLINE PubMed y PubMed CENTRAL desde 1991 hasta 2009, combinando las palabras: «hernia», «laparoscopy» y «trocar», obtuvimos 545 artículos de los cuales analizamos 60.

La incidencia de las EOT oscila entre el 0,18 y 2,8%.

El diámetro del trocar, la obesidad y la edad juegan un papel primordial a la hora de proceder al cierre de la fascia, cierre que es el factor más importante para prevenir la aparición de dichas eventraciones.

La aparición de nuevo material de laparoscopia y el cierre cada vez más frecuente de los defectos de la fascia hacen necesarios nuevos y más extensos estudios prospectivos.

Palabras clave:
Eventración orificios trocares
Hernia
Laparoscopia
El Texto completo está disponible en PDF
References
[1.]
M. Rosen, J. Ponsky.
Minimally invasive surgery.
Endoscopy, 33 (2001), pp. 358-366
[2.]
J.J. Duron, J.M. Hay, S. Msika, et al.
Prevalence and mechanisms of small intestinal obstruction following laparoscopic abdominal surgery: a retrospective multicenter study.
Arch Surg, 135 (2000), pp. 208-212
[3.]
H. Tonouchi, Y. Ohmori, M. Kobayashi, M. Kusunoki.
Trocar site hernia.
Arch Surg, 139 (2004), pp. 1248-1256
[4.]
R.E. Fear.
Laparoscopy: a valuable aid in gynecologic diagnosis.
Obstet Gynecol, 31 (1968), pp. 297-309
[5.]
F.J. Montz, C.H. Holschneider, M.G. Munro.
Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists.
Obstet Gynecol, 84 (1994), pp. 881-884
[6.]
N. Kadar, H. Reich, C.Y. Liu, G.F. Manko, R. Gimpelson.
Incisional hernias after major laparoscopic gynecologic procedures.
Am J Obstet Gynecol, 168 (1993), pp. 1493-1495
[7.]
B.D. Matthews, B.T. Heniford, R.F. Sing.
Preperitoneal Richter hernia after a laparoscopic gastric bypass.
Surg Laparosc Endosc Percutan Tech, 10 (2001), pp. 34-38
[8.]
D.R. Cottam, P.J. Gorecki, M. Curvelo, D. Weltman, L.D. Angus, G. Shaftan.
Preperitoneal herniation into a laparoscopic port site without a fascial defect.
Obes Surg, 12 (2002), pp. 121-123
[9.]
D.J. Azurin, L.S. Go, L.R. Arroyo, M.L. Kirkland.
Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia.
Am Surg, 61 (1995), pp. 718-720
[10.]
D. Rabinerson, O. Avrech, A. Neri, A. Aschoenfeld.
Incisional hernias after laparoscopy.
Obstet Gynecol Surv, 52 (1997), pp. 701-703
[11.]
W.J. Plaus.
Laparoscopic trocar site hernias.
J Laparoendosc Surg, 3 (1993), pp. 567-570
[12.]
A. Maio, R.B. Ruchman.
CT diagnosis of post laparoscopic hernia.
J Comput Assist Tomogr, 15 (1991), pp. 1054-1055
[13.]
J. Mayol, J. García-Aguilar, E. Ortiz-Oshiro, J.A. De Diego Carmona, J.A. Fernández-Represa.
Risks of the minimal access approach for laparoscopic surgery: multivariate analysis f morbidity related to umbilical trocar insertion.
World J Surg, 21 (1997), pp. 529-533
[14.]
A.H. Nassar, K.A. Ashkar, A.A. Rashed, M.G. Abdulmoneum.
Laparoscopic cholecystectomy and the umbilicus.
Br J Surg, 84 (1997), pp. 630-633
[15.]
N. Al-Haijar, S. Duca, G. Molnar, A. Vasilescu, N. Nicolescu.
Incidents and postoperative complications of laparoscopic cholecystectomies for acute cholecystitis.
Rom J Gastroenterol, 11 (2002), pp. 115-119
[16.]
S.A. Ahmad, A.L. Schuricht, D.J. Azurin, L.R. Arroyo, D.L. Paskin, A.H. Bar, et al.
Complications of laparoscopic cholecystectomy: the experience of a university-affiliated teaching hospital.
J Laparoendosc Adv Surg Tech A, 7 (1997), pp. 29-35
[17.]
G.M. Larson, G.C. Vitale, J. Casey, C.R. Voyles.
Multipractice analysis of laparoscopic cholecystectomy in 1983 patients.
Am J Surg, 163 (1992), pp. 221-226
[18.]
I. Birdi, T.M. Hunt, P.S. Veltch, M. Armon, P. Jervis, C. Barr.
Laparoscopic cholecistectomy in Leicester:an audit of 555 patients.
Ann R Coll Surg Engl, 76 (1994), pp. 390-395
[19.]
C.R. Voyles, A.B. Petro, A.L. Meena, A.J. Hqaick, A.M. Koury.
A practical approach to laparoscopic cholecystectomy.
Am J Surg, 161 (1991), pp. 365-370
[20.]
S. Duca, O. Bala, N. Al-Hajjar, C. Iancus, I.C. Piua, D. Munteanu, et al.
Laparoscopic cholecistectomy:incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations.
HBP, 3 (2003), pp. 152-158
[21.]
D.R. Baird, J.P. Wilson, E.M. Mason, T.D. Duncan, J.S. Evans, J.P. Luke, et al.
An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital.
Am Surg, 58 (1992), pp. 206-210
[22.]
J. Lumley, R. Stitz, A. Stevenson, G. Fielding, A. Luck.
Laparoscopic colorectal surgery for cancer:intermediate to long-term outcomes.
Dis Colon Rectum, 45 (2002), pp. 867-872
[23.]
J.G. Berthou, P. Charbonneau.
Elective laparoscopic management of sigmoid diverticulitis: results in a series of 110 patients.
Surg Endosc, 13 (1999), pp. 457-460
[24.]
P.R. Schauer, S. Ikrammudin, W. Gourash, R. Ramanathan, J. Luketich.
Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.
Ann Surg, 232 (2000), pp. 515-529
[25.]
A. Dresel, J.A. Kuhn, M.V. Westmoreland, L.J. Talaasen, T.M. McCarty.
Establishing a laparoscopic gastric bypass program.
Am J Surg, 184 (2002), pp. 617-620
[26.]
J.M. Chevallier, F. Zinzindohoué, N. Elian, A. Cherrak, J.P. Blanche, J.L. Berta, et al.
Adjustable gastric banding in a public university hospital:prospective analysis of 400 patients.
Obes Surg, 12 (2002), pp. 93-99
[27.]
H.Y. Uslu, A.B. Erkek, A. Cakmak, I. Kepenekci, U. Sozener, F.A. Kocaay, et al.
Trocar site hernia after laparoscopic cholecystectomy.
J Laparoendosc Adv Surg Tech A, 17 (2007), pp. 600-603
[28.]
M.P. Callery, S.M. Strasber, N.J. Soper.
Complications of laparoscopic general surgery.
Gastrointest Endosc Clin N Am, 6 (1996), pp. 423-444
[29.]
A. Coda, M. Bossotti, M. Ferri, R. Mattio, G. Ramellini, A. Poma, et al.
Incisional hernia and fascial defect following laparoscopic surgery.
Surg Laparosc Endosc Percutan Tech, 10 (2000), pp. 34-38
[30.]
D.J. Bowrey, D. Blom, P.F. Crookes, C.G. Bremner, J.L. Johansson, R.V. Lord, et al.
Risk factors and the prevalence of trocar site herniation after laparoscopic funduplication.
Surg Endosc, 15 (2001), pp. 663-666
[31.]
S. Susmallian, T. Ezri, I. Charuzi.
Laparoscopic repair of access port site hernia after Lap-band system implantation.
Obes Surg, 12 (2002), pp. 682-684
[32.]
R. Sanz López, C. Martínez Ramos, J.R. Núñez Pena, M. Ruiz de Gopegui, L. Pastor Sirera, S. Tamales Escobar.
Incisional hernias after laparoscopic vs. open cholecystectomy.
Surg Endosc, 13 (1999), pp. 922-924
[33.]
I. Matter, E. Nash, J. Abrahamson, S. Eldar.
Incisional hernia via a lateral 5-mm trocar port following laparoscopic cholecystectomy.
Isr J Med Sci, 32 (1996), pp. 790-791
[34.]
A. Imme, F. Cardi.
Incisional hernia at the trocar site in laparoscopic surgery.
Chir Ital, 58 (2006), pp. 605-609
[35.]
E. Bender, H. Sell.
Small bowel obstruction after laparoscopic cholecystectomy as a result of a Maydl's herniation of the small bowel through a trocar site.
Surgery, 119 (1996), pp. 480
[36.]
A.N. Freedman, H.H. Sigman.
Incarcerated paraumbilical incisional hernia and abscess:complications of a spilled gallstone.
J Laparoendosc Surg, 5 (1995), pp. 189-191
[37.]
J.C. Boughey, J.M. Nottingham, A.C. Walls.
Richter's hernia in the laparoscopic era:four case reports and review of the literature.
Surg Laparosc Endosc Percutan Tech, 13 (2003), pp. 55-58
[38.]
R.J. Fitzgibbons, R. Annibali, B.S. Litke.
Gallsbladder and gallstone removal, open versus closed laparoscopy, and pneumoperitoneum.
Am J Surg, 165 (1993), pp. 497-504
[39.]
M. Wagner, G.E. Farley.
Incarcerated hernia with intestinal obstruction after laparoscopic Cholecistectomy.
WMJ, 93 (1994), pp. 169-171
[40.]
K. Nakajima, M. Wasa, H. Kawahara, T. Hasegawa, H. Soh, E. Taniguchi, et al.
Revision laparoscopy for incarcerated hernia at a 5-mm trocar site following pediatric laparoscopic surgery.
Surg Laparosc Endosc Percutan Tech, 9 (1999), pp. 294-295
[41.]
P.R. Reardon, A. Preciado, T. Scarborough, B. Matthews, Marti JL.
Hernia at 5-mm laparoscopic port site presenting as early postoperative small bowel obstruction.
J Laparoendosc Adv Surg Tech A, 9 (1999), pp. 523-525
[42.]
K. Paya, J. Wurm, M. Fakhari, Felder, R. Puig, S. Puig.
Trocar site hernia as a typical postoperative complicactions of minimally invasive surgery among preschool children.
Surg Endosc, 22 (2008), pp. 2724-2727
[43.]
J.H. Waldhaussen.
Incisional hernia in a 5-mm trocar site following pediatric laparoscopy.
J Laparoendosc Surg, 6 (1996), pp. S89-S90
[44.]
P.G. Horgan, P.R. O’Connell.
Subumbilical hernia following laparoscopic cholecystectomy.
Br J Surg, 80 (1993), pp. 1595
[45.]
B.E. Hass, R.E. Schrager.
Small bowel obstruction due to Richter's hernia after laparoscopic procedures.
J Laparoendosc Surg, 3 (1993), pp. 421-423
[46.]
D.W. Crist, T.R. Gadacz.
Complications of laparoscopic surgery.
Surg Clin North Am, 73 (1993), pp. 265-289
[47.]
C.S. Ramachandran.
Umbilical hernial defects encountered before and after abdominal laparoscopic procedures.
Int Surg, 83 (1998), pp. 171-173
[48.]
I.H. Kulacoglu.
Regarding: Small bowel obstruction and incisional hernia after laparoscopic surgery:should 5-mm trocar sites be sutured?.
J Laparoendosc Adv Surg Tech A, 10 (2000), pp. 227-228
[49.]
J.H. Lee, W. Kim.
Strangulated small bowel hernia through the port site: a case report.
World J Gastroenterol, 14 (2008), pp. 6881-6883
[50.]
J.M. Velasco, V.L. Vallina, S.R. Bonomo, T.J. Hieken.
Post laparoscopic small bowel obstruction:rethinking its management.
Surg Endosc, 12 (1998), pp. 1043-1045
[51.]
C.P. Morrison, S.A. Wemyss-Holden, H. Iswariah, G.J. Maddern.
Lateral laparoscopic port sites should all be closed:the incisional «spigelian» hernia.
Surg Endosc, 16 (2002), pp. 1364
[52.]
I. Petrakis, V. Sciacca, G. Chalkiadakis, S.I. Vassilakis, E. Xynos.
A simple technique for trocar site closure after laparoscopic surgery.
Surg Endosc, 13 (1999), pp. 1249-1251
[53.]
C. Moreno-Sanz, J.S. Picazo-Yeste, M. Manzanera-Díaz, M.L. Herrero-Bogajo, J. Cortina-Oliva, G. Tadeo-Ruiz, et al.
Prevention of trocar site hernias:Description of the safe port plug technique and preliminary results.
Surg Innov, 15 (2008), pp. 100-104
[54.]
A. Sánchez-Pernaute, E. Pérez-Aguirre, A. García Botella, L. Rodríguez, E.M. Antona, J. Cabeza, et al.
Prophylactic closure of trocar orifices with an intraperitoneal mesh (ventralex) in laparoscopic bariatric surgery.
Obes Surg, 18 (2008), pp. 1489-1491
[55.]
B.J. Leibl, C.G. Schmedt, J. Schwarz, K. Kraft, R. Bittner.
Laparoscopic surgery complications associated with trocar tip design:review of literature and own results.
J Laparoendosc Adv Surg Tech A, 9 (1999), pp. 135-140
[56.]
S. Bhoyrul, J. Payne, B. Steffes, L. Swanstrom, L.W. Way.
A randomized prospective study of radially expanding trocars in laparoscopic surgery.
J Gastrointest Surg, 4 (2000), pp. 392-397
[57.]
Holzinger F.
Trocar site hernias. A rare but potentially dangerous complicaction of laparoscopic surgery.
Chirurg, 73 (2002), pp. 899-904
[58.]
W.H. Johnson, A.M. Fecher, R.L. McMahon, J.P. Grant, A.D. Pryor.
VersaStep trocar hernia rate in unclosed fascial defects in bariatric patients.
Surg Endosc, 20 (2006), pp. 1584-1586
[59.]
C.D. Liu, D.W. McFadden.
Laparoscopic port sites do not require fascial closure when nonbladed trocars are used.
Am Surg, 66 (2000), pp. 853-854
[60.]
E. Boldó, G. Perez de Lucia, J.P. Aracil, F. Martin, J. Escrig, D. Martinez, et al.
Trocar site hernia afer laparoscopic ventral hernia repair.
Surg Endosc, 21 (2007), pp. 798-800
Copyright © 2011. Asociación Española de Cirujanos
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos