THE COMPARISON OF PORT -SITE HERNIA IN OPEN VERSUS CLOSED TECHNIQUES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

Background: Port-site hernia is a rare but potentially serious complication of laparoscopic cholecystectomy. This
study aimed to review the current literature, assess the incidence and causes of port-site hernias, and identify
methods to reduce the risk.
Methods: The study was carried out at Surgical ‘B’ unit, PGMI LRH Peshawar from January 2008 to January 2010.It
was a Prospective Interventional Randomized study.All patients suffering from symptomatic Gallstone underwent
clinical evaluation and appropriate investigations. Patients who underwent laparoscopic cholecystectomy the
frequency of port-site hernia in both open and closed method was analyzed. The objective of the study was to
compare the frequency of port-site hernia in both open and closed techniques in laparoscopic cholecystectomy.
Results: 400 laparoscopic cholecystectomy were done. 200 patients by open technique and 200 patients by closed
technique. Among them 350(75%) were female and 50(25%) were male. The youngest patient was 26 years of age
while the oldest 70 years of age. Out of 400 patients, 4(1%) patients had port-site hernia. 1(0.5%) patient having port-
site hernia had open technique, while the remaining 3(1.5%) patients who developed port-site hernia had closed
technique (p=0.004).
Conclusion: Meticulous closure of the fascia, avoidance of unnecessary wound extension, the use of non-absorbable
sutures when faced with defects more than 2 cms in size. Completely defining the extent of pre-existing hernia and
repairing this at the time of port site closure, are recommended to minimize the incidence of port-site hernia after
laparoscopic surgery.
Key Words: Laparoscopic cholecystectomy, Hasson technique, Port-site hernia (PSH) , Trocar-site hernia , Veress
needle.