Unclosed Fascial Defect: Is It the Risk to Develop Port-Site Hernia after Laparoscopic Cholecystectomy?

Somard Tangjaroen MD*, Prasit Watanapa MD, PhD, FRCSEd, FACS**

Affiliation : * Division of Surgery, Kalasin Hospital, Kalasin, Thailand ** Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Objective : Port-site hernia (PSH) is one of the complications after laparoscopic cholecystectomy (LC). Closure of the fascial defect has been mentioned to prevent such complication. However, the results are still controversial. The present study was done to clarify whether unclosed fascial defect was actually the risk factor for the development of PSH. Material and Method: Two hundred ninety four patients underwent LC by a single surgeon at Kalasin Hospital between 2007 and 2010. The procedure was done by using a four-port technique without closure of any fascial defects. The male:female ratio was 85:209, and the mean body mass index was 24.383.33 (SD). The mean operative time was 18.713.76 minutes and there was no postoperative wound infection. Patients were regularly followed-up and underwent both supine and upright physical examination. The mean duration of follow-up period was 4.941.31 years with the shortest follow-up period of two years.
Results : None of the patients in the present study developed PSH in any port sites during the follow-up period.
Conclusion : Unclosed fascial defect may not have the significant risk factor of developing PSH after LC.

Keywords : Port-site hernia, Laparoscopic cholecystectomy

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