Systematic review of trocar-site hernia

Background: Broad implementation of laparoscopic surgery has made trocar‐related complications clinically important. Trocar‐site hernia (TSH) is an uncommon, but potentially serious, complication that occasionally requires emergency surgery. This systematic review was conducted to establish the prev...

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Bibliographic Details
Published in:British journal of surgery 2012-03, Vol.99 (3), p.315-323
Main Authors: Swank, H. A., Mulder, I. M., la Chapelle, C. F., Reitsma, J. B., Lange, J. F., Bemelman, W. A.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Bariatric Surgery - adverse effects
Biological and medical sciences
Body Mass Index
Epidemiologic Methods
Equipment Design
Female
Gastrointestinal Diseases - surgery
General aspects
Gynecologic Surgical Procedures - adverse effects
Hernia - etiology
Herniorrhaphy - methods
Humans
Laparoscopy - adverse effects
Laparoscopy - instrumentation
Length of Stay
Male
Medical sciences
Middle Aged
Miscellaneous
Public health. Hygiene
Public health. Hygiene-occupational medicine
Reoperation - statistics & numerical data
Sex Factors
Surgical Instruments - adverse effects
Surgical Wound Infection - complications
Urologic Surgical Procedures - adverse effects
Wound Closure Techniques - adverse effects
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Summary:Background: Broad implementation of laparoscopic surgery has made trocar‐related complications clinically important. Trocar‐site hernia (TSH) is an uncommon, but potentially serious, complication that occasionally requires emergency surgery. This systematic review was conducted to establish the prevalence and risk factors for TSH. Methods: The review was conducted according to the PRISMA guidelines. MEDLINE, Embase, Web of Science and the Cochrane Library were searched to 7 June 2010 for studies on TSH. Results: Twenty‐two articles were included. One study was a randomized clinical trial, five were prospective cohort studies and 16 were retrospective cohort studies. The prevalence of TSH is low, with a median pooled estimate of 0·5 (range 0–5·2) per cent. No meta‐analysis on risk factors could be performed. Pyramidal trocars, 12‐mm trocars and a long duration of surgery were identified as the most important technical risk factors for TSH. Older age and a higher body mass index were observed to be patient‐related risk factors. Conclusion: TSH is an uncommon complication of laparoscopic surgery. The most important technical risk factors are the design and size of the trocars. The scientific evidence for recommendations to avoid TSH is sparse. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Technical aspects most important
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.7836