Simple technique for proper approximation and closure of peritoneal and rectus sheath defects at port site after laparoscopic surgery.

Complex intra-abdominal surgical procedures can now be performed with laparoscopy, and laparoscopic cholecystectomy has become the gold standard in the care of patients with cholelithiasis. This and other surgically challenging procedures involve use of multiple large (10-mm-15-mm) ports. A standard laparoscopic cholecystectomy employs two 10-mm trocar incisions. Development of incisional hernia from these port sites is well recognized unless the rectus sheath is closed properly. This makes proper closure of the incisions for larger ports critical, especially 10-mm to 15-mm ports. However, securing abdominal wall bleeding and closing facial defects through a small incision can be a cumbersome task. We have developed a simple technique using the regular curved needle and sutures for closure of rectus sheath defects through a small port-site incision.