Influencing factors for port-site hernias after single-incision laparoscopy

F. P. Buckley, H. E. Vassaur, Daniel Jupiter, J. H. Crosby, C. J. Wheeless, J. L. Vassaur

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Single-incision laparoscopic surgery (SILS) has been demonstrated to be a feasible alternative to multiport laparoscopy, but concerns over port-site incisional hernias have not been well addressed. A retrospective study was performed to determine the rate of port-site hernias as well as influencing risk factors for developing this complication. Methods: A review of all consecutive patients who underwent SILS over 4 years was conducted using electronic medical records in a multi-specialty integrated healthcare system. Statistical evaluation included descriptive analysis of demographics in addition to bivariate and multivariate analyses of potential risk factors, which were age, gender, BMI, procedure, existing insertion-site hernia, wound infection, tobacco use, steroid use, and diabetes. Results: 787 patients who underwent SILS without conversion to open were reviewed. There were 454 cholecystectomies, 189 appendectomies, 72 colectomies, 21 fundoplications, 15 transabdominal inguinal herniorrhaphies, and 36 other surgeries. Cases included 532 (67.6 %) women, and among all patients mean age was 44.65 (±19.05) years and mean BMI of 28.04 (±6). Of these, 50 (6.35 %) patients were documented as developing port-site incisional hernias by a health care provider or by incidental imaging. Of the risk factors analyzed, insertion-site hernia, age, and BMI were significant. Multivariate analysis indicated that both preexisting hernia and BMI were significant risk factors (p value = 0.00212; p value = 0.0307). Morbidly obese patients had the highest incidence of incisional hernias at 18.18 % (p value = 0.02). Conclusions: When selecting patients for SILS, surgeons should consider the presence of an umbilical hernia, increased age and obesity as risk factors for developing a port-site hernia.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalHernia : the journal of hernias and abdominal wall surgery
DOIs
StateAccepted/In press - Jul 14 2016
Externally publishedYes

Fingerprint

Hernia
Laparoscopy
Multivariate Analysis
Umbilical Hernia
Fundoplication
Appendectomy
Colectomy
Groin
Electronic Health Records
Herniorrhaphy
Tobacco Use
Cholecystectomy
Wound Infection
Health Personnel
Retrospective Studies
Obesity
Steroids
Demography
Delivery of Health Care
Incidence

Keywords

  • Incisional hernia
  • Port-site hernias
  • Risk factors
  • Single-incision laparoscopy

ASJC Scopus subject areas

  • Surgery

Cite this

Influencing factors for port-site hernias after single-incision laparoscopy. / Buckley, F. P.; Vassaur, H. E.; Jupiter, Daniel; Crosby, J. H.; Wheeless, C. J.; Vassaur, J. L.

In: Hernia : the journal of hernias and abdominal wall surgery, 14.07.2016, p. 1-5.

Research output: Contribution to journalArticle

Buckley, F. P. ; Vassaur, H. E. ; Jupiter, Daniel ; Crosby, J. H. ; Wheeless, C. J. ; Vassaur, J. L. / Influencing factors for port-site hernias after single-incision laparoscopy. In: Hernia : the journal of hernias and abdominal wall surgery. 2016 ; pp. 1-5.
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AU - Vassaur, H. E.

AU - Jupiter, Daniel

AU - Crosby, J. H.

AU - Wheeless, C. J.

AU - Vassaur, J. L.

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AB - Purpose: Single-incision laparoscopic surgery (SILS) has been demonstrated to be a feasible alternative to multiport laparoscopy, but concerns over port-site incisional hernias have not been well addressed. A retrospective study was performed to determine the rate of port-site hernias as well as influencing risk factors for developing this complication. Methods: A review of all consecutive patients who underwent SILS over 4 years was conducted using electronic medical records in a multi-specialty integrated healthcare system. Statistical evaluation included descriptive analysis of demographics in addition to bivariate and multivariate analyses of potential risk factors, which were age, gender, BMI, procedure, existing insertion-site hernia, wound infection, tobacco use, steroid use, and diabetes. Results: 787 patients who underwent SILS without conversion to open were reviewed. There were 454 cholecystectomies, 189 appendectomies, 72 colectomies, 21 fundoplications, 15 transabdominal inguinal herniorrhaphies, and 36 other surgeries. Cases included 532 (67.6 %) women, and among all patients mean age was 44.65 (±19.05) years and mean BMI of 28.04 (±6). Of these, 50 (6.35 %) patients were documented as developing port-site incisional hernias by a health care provider or by incidental imaging. Of the risk factors analyzed, insertion-site hernia, age, and BMI were significant. Multivariate analysis indicated that both preexisting hernia and BMI were significant risk factors (p value = 0.00212; p value = 0.0307). Morbidly obese patients had the highest incidence of incisional hernias at 18.18 % (p value = 0.02). Conclusions: When selecting patients for SILS, surgeons should consider the presence of an umbilical hernia, increased age and obesity as risk factors for developing a port-site hernia.

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KW - Risk factors

KW - Single-incision laparoscopy

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