Retrospective single-surgeon study of outcomes after laparoendoscopic single-site cholecystectomy and sigmoidectomy

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2016-02, Vol.20 (1), p.15-20
• Main Authors: Smirnoff, A., de Poncheville, L., Allix-Béguec, C., Lefant, P.-Y., Drapier, E.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adolescent; Adult; Aged; Aged, 80 and over; Biliary Tract Surgical Procedures - adverse effects; Biliary Tract Surgical Procedures - methods; Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - methods; Colon, Sigmoid - surgery; Digestive System Diseases - surgery; Female; Hemorrhage - etiology; Hemorrhage - therapy; Hernia, Umbilical - etiology; Hernia, Umbilical - surgery; Humans; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Retrospective Studies; Surgical Instruments - adverse effects; Surgical Wound Infection - etiology; Surgical Wound Infection - therapy; Treatment Outcome; Young Adult
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-015-1434-x

Purpose Laparoendoscopic single-site (LESS) surgery is performed through a single port but requires a larger incision than conventional laparoscopy, which theoretically increases the risk of laparoscopic port hernia. Our primary objective is to determine the trocar site hernia rate among our patients. Methods This retrospective study is based on the analysis of demographic, intraoperative, and postoperative data of 219 patients who underwent cholecystectomy or sigmoidectomy by LESS surgery between December 1st, 2009 and November 30th, 2012. Results Cholecystectomy and sigmoidectomy LESS surgery were performed on 190 and 29 patients, respectively. Three patients developed a trocar site hernia within a median follow-up time of 34.7 months. Eleven patients were obese, 20 had a history of abdominal surgery, and 20 had a preoperative umbilical hernia but none of them developed a trocar site hernia, neither did the 11 subsequently pregnant women. Significant association was found between preoperative umbilical hernia and early complications including incisional cellulitis and hematoma. Conclusions A rate of 1.4 % of trocar site hernia was observed in our study population. This rate is similar to the one reported after conventional laparoscopy. Peri-umbilical incision, longer than that with conventional laparoscopy, allowed better preexisting hernia handling, made anatomical closing easier among obese patients, and facilitated specimen extraction thus limiting traumatic operations.