Dr. José Antonio Pereira

Incidence of trocar and assistance incision hernia

One of the advantages of laparoscopic procedures over open surgery is the lower incidence of hernias, but some studies actually show similar rates for both techniques. If incisional hernias are not less frequent in laparoscopic surgery, as data from Dr. Pereira’s working team shows, prophylactic measures should be considered. In a retrospective study of 182 patients who underwent midline and non-midline laparotomy assistance in laparoscopic colorectal procedures, a higher rate of incisional hernia was found in midline assistance incisions. This difference seems to disappear when a prophylactic mesh is used in midline incisions for patients considered to have a higher risk of incisional hernia (BMI over 30 and COPD), achieving a similar rate of incisional hernia in both midline and non midline laparotomies. Dr. Pereira concludes that incisional hernia is frequent after laparoscopic colorectal procedures, especially after midline laparotomy. The incidence of trocar hernia is higher in non midline laparotomy assistance. Avoiding midline assistance incisions seems to be the best way to reduce incisional hernias, and the use of a prophylactic mesh when performing a midline incision in high-risk patients should be considered.