Is the port site really at risk? Biology, mechanisms and prevention: a critical view.

Early case reports of port site tumour implants led to debate regarding the appropriateness of laparoscopic techniques for abdominal malignancies. Review of clinical, animal and cell culture studies addresses the relationships between tumour staging and shed cell behaviour that contributes to the peri-operative spread of tumours. In addition, a porcine model was used to test tumour cell distribution after laparoscopic and open colonic resections. Clinical evidence indicate that wound recurrence rates are 0.60 and 0.85% for open and laparoscopic colon cancer operations, respectively. Tumour staging and operative techniques are the most important factors determining wound implantation. Port site and open wounds are at equal risk of tumour implantation.