[Trocar site hernias. A rare but potentially dangerous complication of laparoscopic surgery]

Abstract

With increasing numbers of laparoscopic procedures more postoperative trocar site hernias can be expected. This complication of minimally invasive surgery is rare but potentially dangerous. According to the literature, the overall incidence of trocar site hernias is expected to be around 1%. Among trocar site hernias, Richter's hernias are the most frequent, accounting for two-thirds of all small intestinal hernias. The following risk factors for the development of trocar site hernias have been identified: the trocar diameter, the trocar design, preexisting fascial defects, and some operation- and patient-related factors. Peritoneal and fascial closure should be done when blunt trocars of >10 mm have been employed. Based on the literature and our own experience, some preventive recommendations are given to further reduce the risk of hernia formation at trocar sites.