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The incidence of trocar-site hernia in minimally invasive bariatric surgery: A comparison of multi versus single-port laparoscopy

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Abstract

Introduction

Single-port laparoscopy (SPL) employs a 1.5- to 2.5-cm incision at the umbilicus for the placement of a single working port. We hypothesized that the longer incision created by SPL compared with multiport laparoscopy may increase the incidence of trocar-site hernias. We examined our experience with SPL in bariatric operations.

Methods

There were 734 laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding procedures performed at our institution between 2001 and 2011. Fifty-eight patients were lost to follow-up or had a short duration of follow-up (<1 month). Of the remaining 676 cases, 163 were performed via SPL. All laparoscopic wounds created by trocar size greater than 12 mm were closed with absorbable suture.

Results

Patient demographics of the SPL group and the multiport group were similar in terms of age, gender, and comorbidities. The average body mass index (BMI) of the SPL group was lower than the multiport group (43.5 ± 5.3 vs. 45.8 ± 7.7, p < 0.01). The mean follow-up for the SPL group was 11 months versus 24 months for the multiport group. There were three trocar-site hernias out of 513 cases in the multiport compared to one hernia out of 163 cases in the SPL group (0.6 vs. 0.6 %, p = 0.967). All trocar-site hernias occurred at the 15-mm port site. The median time to hernia occurrence for the multiport group was 13 months (range, 1–18). In the SPL group, the hernia occurred at 8 months. On multivariate analysis, age, BMI, SPL, procedure type, and the postoperative weight loss were not associated with the development of trocar-site hernias.

Conclusions

SPL did not increase the rate of trocar-site hernia in this series. A low rate of trocar-site hernia can be achieved with the use of SPL in bariatric surgery.

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Acknowledgments

The authors are grateful to Ms. Dina Corjuc for assistance with data collection and analysis.

Disclosures

This study did not require funding from any source. Drs. Lee, Rehmani, Guend, Park, Ross, Alkhalifa and McGinty have no financial relationships or conflict of interest to disclose. Dr. Teixeira is a teaching consultant for Allergan and Covidien.

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Authors and Affiliations

  1. St. Luke’s-Roosevelt Hospital Center, Institute for Bariatric and Minimally Invasive Surgery, 1111 Amsterdam Avenue, Babcock 4W, New York, NY, 10025, USA

    David Y. Lee, Sadiq S. Rehmani, Hamza Guend, Koji Park, Ronald E. Ross, Mohammed Alkhalifa, James J. McGinty & Julio A. Teixeira

  2. Department of Surgery, Columbia University College of Physicians and Surgeons, 1000 Tenth Ave. 2B, New York, NY, 10019, USA

    James J. McGinty & Julio A. Teixeira

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  1. David Y. Lee
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  2. Sadiq S. Rehmani
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  3. Hamza Guend
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  4. Koji Park
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  6. Mohammed Alkhalifa
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  8. Julio A. Teixeira
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Correspondence to David Y. Lee.

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Lee, D.Y., Rehmani, S.S., Guend, H. et al. The incidence of trocar-site hernia in minimally invasive bariatric surgery: A comparison of multi versus single-port laparoscopy. Surg Endosc 27, 1287–1291 (2013). https://doi.org/10.1007/s00464-012-2597-5

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  • DOI: https://doi.org/10.1007/s00464-012-2597-5

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