Trocar site hernia after laparoscopic ventral hernia repair.

BACKGROUND

The incidence of trocar site hernia (TSH) after laparoscopic ventral hernia repair (LVHR) is reported to be low. The present study investigates the associated risk factors, with a view to preventing this complication.

METHODS

A retrospective study was made of the incidence of TSH in a personal series of LVHR, recording anthropometric and clinical data on the patients. Risk factors were assessed by bivariate and multivariate analyses. The patients were subjected to clinical and telephone follow-up.

RESULTS

In a series of 27 LVHR, the incidence of TSH was 22% (6 patients). The use of meshes larger than 10 x 15 cm for LVHR was the only TSH risk factor to reach statistical significance. Female gender and diabetes showed a higher incidence in the TSH group.

CONCLUSIONS

The use of large meshes may be a risk factor for TSH. We believe this to be due to dilatation of the trocar orifice during introduction of the mesh, and also to postoperative retraction of the mesh.