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.
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.
Authors: A Coda; M Bossotti; F Ferri; R Mattio; G Ramellini; A Poma; F Quaglino; C Filippa; A Bona Journal: Surg Laparosc Endosc Percutan Tech Date: 2000-02 Impact factor: 1.719
Authors: D J Bowrey; D Blom; P F Crookes; C G Bremner; J L Johansson; R V Lord; J A Hagen; S R DeMeester; T R DeMeester; J H Peters Journal: Surg Endosc Date: 2001-05-11 Impact factor: 4.584
Authors: R Sanz-López; C Martínez-Ramos; J R Núñez-Peña; M Ruiz de Gopegui; L Pastor-Sirera; S Tamames-Escobar Journal: Surg Endosc Date: 1999-09 Impact factor: 4.584
Authors: Henry Mercoli; Stylianos Tzedakis; Antonio D'Urso; Marius Nedelcu; Riccardo Memeo; Nicolas Meyer; Michel Vix; Silvana Perretta; Didier Mutter Journal: Surg Endosc Date: 2016-08-05 Impact factor: 4.584
Authors: Pouya Iranmanesh; Angielyn R Rivera; Kulvinder S Bajwa; Mustafa Alibhai; Brad E Snyder; Todd D Wilson; Melissa M Felinski; Sheilendra S Mehta; Kavita D Chandwani; Connie L Klein; Peter A Walker; Shinil K Shah; Erik B Wilson Journal: Surg Endosc Date: 2019-06-10 Impact factor: 4.584
Authors: Andreas Domen; Cedric Stabel; Rami Jawad; Nicolas Duchateau; Erik Fransen; Patrick Vanclooster; Charles de Gheldere Journal: Langenbecks Arch Surg Date: 2020-05-31 Impact factor: 3.445