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HOW I DO IT DIFFERENTLY
Year : 2010  |  Volume : 6  |  Issue : 1  |  Page : 22-23
 

Port site closure after laparoscopic surgery


Department of Surgery, Prince Charles Hospital, Merthyr Tydfil, Wales, United Kingdom

Date of Submission22-Dec-2009
Date of Acceptance02-Feb-2010
Date of Web Publication15-Apr-2010

Correspondence Address:
P R Shah
Modular building 2, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.62534

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 ¤ Abstract 

We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation.


Keywords: Hernia, laparoscopic surgery, port site closure, port site


How to cite this article:
Shah P R, Naguib N, Thippeswammy K, Masoud A G. Port site closure after laparoscopic surgery. J Min Access Surg 2010;6:22-3

How to cite this URL:
Shah P R, Naguib N, Thippeswammy K, Masoud A G. Port site closure after laparoscopic surgery. J Min Access Surg [serial online] 2010 [cited 2019 Dec 7];6:22-3. Available from: http://www.journalofmas.com/text.asp?2010/6/1/22/62534



 ¤ Technical Tip Top


We would like to report a novel method for the closure of the port site in laparoscopic surgery. There are usually 5 mm, 10 mm and 12 mm ports in laparoscopic surgery. The literature search reveals that the hernia through the port site can cause considerable morbidity in a post-operative patient especially requiring surgical intervention. [1] The use of bio-absorbable hernia plug has been recommended to prevent this hernias. [2] The non-bladed, radially dilating and conical blunt devices are also not without hazards of hernia. [3]

We routinely use Hassan's port for causing pneumo-peritoneum which is then closed under vision. The lateral 10 to 12 mm ports are closed using vicryl with the help of a skin hook and a retractor (small Langenbach right angled retractor or skin hook). Skin hook is inserted in the corner of the wound under the sheath. This can now be palpated with the finger very easily as the sheath is taut. This also causes approximation of the sheath which can now be accessed by using another retractor (right angled retractor/skin hook) above the sheath at 90 degrees to the hook (inserted under sheath) to retract skin and subcutaneous tissue [Figure 1]. The edge of the sheath is picked up with tooth forceps and a stitch is taken via one leaf of the sheath and the procedure is repeated by moving the retractor to the opposite edge to identify the other leaf of the sheath [Figure 2]. We have used this technique in our unit since last 7 years in over 120 laparoscopic bowel resection and fundoplications without single port site hernia.

 
 ¤ References Top

1.Lee JH, Kim W. Strangulated small bowel hernia through the port site: A case report. World J Gastroenterol 2008;14:6881-3.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Moreno-Sanz C, Picazo-Yeste JS, Manzanera-Díaz M, Herrero-Bogajo ML, Cortina-Oliva J, Tadeo-Ruiz G. Prevention of trocar site hernias: Description of the safe port plug technique and preliminary results. Surg Innov 2008;15:100-4.  Back to cited text no. 2      
3.Kouba EJ, Hubbard JS, Wallen E, Pruthi RS. Incisional hernia in a 12-mm non-bladed trocar site following laparoscopic nephrectomy. Urol Int 2007;79:276-9.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1], [Figure 2]

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