Purpose: Operative laparoscopy has recently been applied in a wide variety of surgical procedures traditionally performed through laparotomy. With wider application of operative laparoscopy, prolonged operative time, and increased complexity of the surgical procedures, more complications are expected following operative laparoscopy. One such complication recently reported with increasing frequency is incisional hernia. The objective of this study was to determine the possible risk factor of incisional hernias after operative laparoscopy.
Methods: From January 1989 to September 2002, 7210 patients underwent operative laparoscopy at the University of Ulsan College of Medicine and Asan Medical Center. We retrospectively reviewed a total of 12 cases of incisional hernia.
Results: The average age of the patients was 60 years. The average body mass index of the patients was 27. Initial laparoscopic procedures varied and included laparoscopic cholecystectomy (three patients), laparoscopic excision of retroperitoneal mass (one patient) and laparoscopic gynecologic procedures (eight patients).
Conclusion: Incisional herniation occurs through ports larger than 10 mm in size at umbilical and extraumbilical sites. The possible risk factors were old age, obesity, larger than 10 mm trocars, prolonged operation times, wound infection and ineffective closure of the fascia. Although the incidence of hernias at the trocar site after laparoscopic surgery is low, every preventive measure possible is needed to ensure one of the most important advantages of this surgical approach. Also attention should be paied to a possible occurrence of incisional hernia at any trocar site after direct closure of the fascia in the late postoperative period.
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