protective effect of body mass index in overweight patients with herniation through unclosed port of trocar: a randomized clinical trial

The incidence of trocar site herniation differs in various studies. The incidence of these hernias is increased in patients who experience significant weight gain postoperatively. The aim of this study was to compare the complication of closed trocar port site with open port and effect of body mass index on the herniation using trocar site incision in laparoscopic surgery. In this prospective, randomized clinical, a total of 100 patients were scheduled to undergo appendectomy, cholecystectomy, ovarian cyst excision, herniorraphy and diagnostic laparoscopy at the Surgical Gastroenterology Service of The Baqiyatallah Hospital. Patients were randomly distributed into group OP [open port, n = 52] and group CP [closed port, n = 48]. The follow up intervals were at 3 and 12 months after surgical operation. Five patients in OP group developed incision hernia. Regarding infection, hematoma, there was no significant difference between the two groups. Surprisingly, in OP group the average BMI [kg/m[2]] in herniated patients was significantly less than nonherniated cases. An important step to avoid post laparoscopic hernias is suturing the fascia whenever the trocar diameter exceeds 10 mm. If surgeons tend to have an open trocar site of 10 mm, particularly in facial defects; the trocar site is protected from incision hernia in obese patients with high BMI

Reduced incidence of early complications of surgical wounds in laparoscopic surgery

Wound-related complications are major sources of trouble in post-operative period and slow down the wound healing process. This study was performed to determine the incidence of early wound related complications in laparoscopic versus open abdominal surgeries. Medical records of 104 elective laparoscopic [A] and 106 diagnosis matched open surgeries [B] including appendectomy, cholecystectomy, ventral hernia repair, and bariatric surgery were retrospectively reviewed between Jun 2002 and Jan 2005. Study data included patients' sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation. The two groups were not different regarding age, sex and wound classes. Wound infection developed in 7 patients [RR: 0.06 [0.01-0.77] [95%CI]] and none in patients of group B. Incidence of Hematoma was similar in the two groups; one case in each. No patients in the two groups experienced seruma nor wound dehiscence. Gender, age, and wound classes were not associated with higher rates of wound complications. Laparoscopic surgery significantly reduced the incidence of early wound complications, namely wound infection, and is a safe and efficient alternative to conventional open procedures