An Expanded Retrospective Review of Trocar Site Hernias in Laparoscopic Gastric Bypass Patients

Abstract Background: Trocar site hernias (TSH) are reported in 0.3% to 5.4% of laparoscopic cases, depending on diameter and type. Most occur with trocars over 10 mm in diameter. Some recommend routine fascial closure, but this requires time, costs, pain, and increased infection rates. All prior series are based on clinical presentation alone. We examined the possibly underreported prevalence of asymptomatic TSH on postoperative computed tomography (CT) scans in a series of laparoscopic gastric bypass (LGBP) patients with unclosed port site fascia. Materials and Methods: After Institutional Review Board (IRB) approval, a retrospective review of all patients undergoing LGBP at our center from 2005 to 2014 was performed. All procedures were performed using dilating optical trocars up to 12 mm diameter, placed above the arcuate line. No fascial closures were performed. Any patients undergoing abdominal CT scanning for any reason in the study period were included; patients who had undergone a separate laparos...