Lateral sided trocar site hernia following laparoscopic hernia repair: results of a long-term follow-up.

PURPOSE: Trocar site hernias (TSH) at the umbilical site following laparoscopic cholecystectomy forms the majority of the studies about TSH and there is a missing data in literature about lateral sided TSH. We aimed to evaluate the incidence and factors affecting lateral sided TSH occurrence following laparoscopic abdominal wall hernia repair (LAHR). METHODS: Patients who underwent LAHR between March 2013 and 2015 were included in the study. Open approach with blunt dissection for optical trocar insertion and z-shaped suture for closure were used in 22 cases initially (Group 1). Sharp dissection and continuous suture for closure were used for the rest of the patients (Group 2). RESULTS: 285 patients-237 females (83.2%) and 48 males (16.8%)-with a mean age of 50.14 ± 12.03 were included in the study. Most of the patients were overweight or obese and mean BMI was 29.25 ± 5.04 kg/m2. BMI was significantly higher in patients with TSH (p:0.025) and TSH occurrence is significantly higher in Group 1 patients (p < 0.001). CONCLUSIONS: Trocar insertion and closure technique have a major role in lateral sided TSH occurrence. Trying to avoid blunt dissection during trocar insertion, closure of trocar site with continuous suture and enlargement of skin incision to provide good view decreases lateral sided TSH occurrence. In addition, increase at the level of BMI has increased the probability of TSH occurrence and further studies are needed to evaluate efficiency of prophylactic prosthetic closure for obese patients.

Lichtenstein or darn procedure in inguinal hernia repair: a prospective randomized comparative study.

BACKGROUND: The aim of this study was to assess the outcome of patients with inguinal hernia where the Moloney darn or Lichtenstein procedure was used as the surgical choice. METHOD: A herniorrhaphy procedure was performed in a total of 306 patients at our clinic between January 2003 and December 2008. The duration of operations and complication and recurrent rates were compared between the two groups. Hematoma formation, seroma collection, and wound infection were accepted as early complications, whereas chronic pain, loss of sensation at the operation site, and the rejection of mesh were accepted as late complications. RESULTS: Considering early complications as hematoma formation, the accumulation of seroma and wound infection ratios were similar in the two groups. Loss of sensation at the operation site and chronic pain, which were classified as late complications, were similar in the groups. However, in considering rejection, there were three rejections in the group where mesh was used. CONCLUSION: The darn repair method is simple, safe, and has similar recurrence rates when compared to the Lichtenstein method in inguinal hernia patients.