Some Consideration about Port Site Hernia after Laparoscopic Surgery.
AJTES Vol 6, No 2, July 2022
Haxhirexha K et al - Some Consideration about Port Site Hernia after Laparoscopic Surgery.


Port site hernias
laparoscopic surgery
incisional hernias

How to Cite

Haxhirexha, K., Dogjani, A., Haxhirexha, A., Haxhirexha, L., Fejzuli, B., & Ademi, A. (2022). Some Consideration about Port Site Hernia after Laparoscopic Surgery. Albanian Journal of Trauma and Emergency Surgery, 6(2), 1029-1032.


Introduction: Port site hernias continue to be a major problem in laparoscopic surgery. The causes of this type of hernia are numerous. The main ones are operative wound infection, obesity, male gender, diabetes, BPH, etc. However, in addition to these factors it seems that in the etiology of post laparoscopic port - site hernias are at least two other factors that have an impact on these complications.

Aim of the article is to assess the role of different factors in the occurrence of port site incisional hernias according to our experience.

Material and Methods:  the 187 patients who were operated on at the General Surgery Department of the Clinical Hospital of Tetovo between January, 2017 and June, 2019 on whom the surgical intervention was performed through laparoscopic techniques were included in this study. The reason for the surgical interventions has been various surgical pathologies of the abdomen such as cholecystolithiasis, acute appendicitis, cysts of the liver, ovaries and kidneys, etc. Postoperative complications in these patients, especially port site hernia will be in the focus of our study.

Results: Out of the total of 187 patients included in this study the occurrence of incisional hernia was recorded in six of them. In five patients the hernia was localized at the site of insertion of the supra-umbilical trocar, while in the other, the trocar was inserted below the xiphoid process. From our records it happened that in all these patients, with postoperative hernia, the insertion of the cannula was done with the cutting trocar. At the same time in all six patients with post laparoscopic hernia the surgical intervention performed was cholecystectomy or appendectomy. Thus, the removal of the gallbladder and appendix, without the use of an Endo-bag, was performed at the site of the hernia presentation. In all these patients the entrance porta infection in which the hernia has occurred, was registered in the early post operative period.

Conclusion: Of the many factors that increase the risk of incisional hernias, at the site of cannula insertion during laparoscopic interventions, it seems that the type of trocar and the place from which the extruded organ is removed, if it is done without the use of an Endo-bag, are very important.
Haxhirexha K et al - Some Consideration about Port Site Hernia after Laparoscopic Surgery.


Reynolds W., Jr The first laparoscopic cholecystectomy. JSLS. 2001; 5 (1): 89–94 [PMC free article] [PubMed] [Google Scholar] [Ref list]

Fear RE. Laparoscopy: a valuable aid in gynaecological diagnosis. Obstet Gynaecol. 1968; 31: 297–309 [PubMed] [Google Scholar] [Ref list]

Maio A, Ruchman RB. CT diagnosis of postlaparoscopic hernia. J Comput Assist Tomogr. 1991. Nov-Dec;15(6):1054–1055 [PubMed] [Google Scholar] [Ref list]

Di Lorenzo N, Coscarella G, Lirosi F, Gaspari A. Port-site closure: a new problem, an old device. JSLS. 2002;6:181–183 [PMC free article] [PubMed] [Google Scholar] [Ref list]

Hussain A, Mahmood H, Singhal T, Balakrishnan S, Nicholls J, El-Hasani S. Long-term study of port-site incisional hernia after laparoscopic procedures. JSLS. 2009; 13 (3): 346–349 [PMC free article] [PubMed] [Google Scholar] [Ref list]

Tonouchi H, Ohmori Y, Kobayashi M, Kusonoki M. Trocar site hernia. Arch Surg. 2004; 139: 1248–1256 [PubMed] [Google Scholar] [Ref list]

Munro MG. Laparoscopic access: complications, technologies, and techniques, Curr Opin Obstet Gynecol. 2002;14:365–374 [PubMed] [Google Scholar] [Ref list]

Bruyere F, Sun J, Cosson JP, Kouri G. Incarceration of bowel through opening of a 5-mm port. J Endourol. 2004;18:675–676 [PubMed] [Google Scholar] [Ref list]

Schmedt C-G, Leibl BJ, Däubler P, Bittner R. Access-related complications–an analysis of 6023 consecutive laparoscopic hernia repairs. Minim Invasive Ther Allied Technol. 2001;10:23–29 [PubMed] [Google Scholar] [Ref list]

Voiculescu S, Jitea N, Burcos T, Cristian D, Angelescu N. Incidents, accidents and complications in laparoscopic surgery. Chirurgia (Bucur). 2000;95:397–399 [PubMed] [Google Scholar] [Ref list]

Owens M, Barry M, Janjua AZ, Winter DC. A systematic review of laparoscopic port site hernias in gastrointestinal surgery. Surgery. 2011;9(4):218–24

Hussain A, Mahmood H, Singhal T, Balakrishnan S, Nicholls J, El-Hasani S. Long-term study of port-site incisional hernia after laparoscopic procedures. JSLS. 2009;13(3):346 –349.

Agaba EA, Rainville H, Ikedilo O, Vemulapali P. Incidence of port-site incisional hernia after single-incision laparoscopic surgery. JSLS. 2014;18(2):204–10.

Boldo´ E, Perez de Lucia G, Aracil JP et al. Trocar site hernia after laparoscopic ventral hernia repair. Surg Endosc. 2007;21(5): 798 – 800.

Haxhirexha, K., Dogjani, A., & Haxhirexha, F. D. (2022). Treatment Options for Incisional Hernias. Albanian Journal of Trauma and Emergency Surgery, 6(1), 929-932.

K H Gad, A M M Elhefny, W B Gerges, M S A Sebaie. Assessment of Port Site Complication in Laparoscopic Abdominal Surgery. International Journal of Medicine, Volume 113, Issue Supplement_1, March 2020.

J. Comajuncosas, J. Hermoso, P. Gris, J. Jimeno, R. Orbeal, H. Vallverdu, et al. Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study. Am J Surg, 207 (2014), pp. 1-6

G.M Eid, J.Collins. Application of a trocar wound closure system designed for Laparoscopic procedure in morbidly obese patients. Obes.Surg. 15 (2005) 871 -873.

Juliana Mika KATO, Leandro Ryuchi IUAMOTO, Fábio Yuji SUGUITA, Felipe Futema ESSU, Alberto MEYER, Wellington ANDRAUS. Impact of obesity and surgical skills in laparoscopic totally extraperitoneal hernioplasty. ABCD Arq Bras Cir Dig Original Article 2017;30(3):169-172.

Cottam DR, Gorecki PJ, Curvelo M, Weltman D, Angus LD, Shaftan G. Preperitoneal herniation into a laparoscopic port site without a fascial defect. Obes Surg. 2002;12: 121-123

Bowrey DJ, Blom D, Crookes PF, et al. Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication. Surg Endosc. 2001

Mayol J, Garcia-Aguilar J, Ortiz-Oshiro E, De-Diego Carmona JA, Fernandez-Represa JA. Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg. 1997; 21:529 –533.

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