Prevention of Port Site Hernia after Laparoscopic-assisted colectomy

Abstract Background Although laparoscopic colorectal cancer resection is becoming increasingly popular, port site hernia (PSH) has remained a problem. It worsens satisfaction and the quality of life. No studies have specifically investigated the use of a GraNeeTM Needle and R-MedTM Plug system (the GraNee Needle system) in this surgical procedure. Thus, the aim of the present study was to determine the incidence of PSH using a grasping needle in a cohort of patients undergoing laparoscopic colorectal cancer resection in comparison with standard closure. Methods We enrolled 672 consecutive patients with colorectal cancer who underwent laparoscopic colorectal resection between June 1993 and December 2008. The GraNee Needle system was introduced into the operation from April 2001 (GraNee Group ; N=388). Prior to this, standard closure was carried out via the defect through the skin wound once the pneumoperitoneum has been released and the port removed (Standard closure group ; N=221). Patient and tumor characteristics, and complication details were extracted from case records retrospectively and used to identify patients who developed PSH. Results The median follow-up periods of standard closure group and Granee Needle group were 52.4 (12-167) and 38.3 (12-128) months, respectively. There were two incidences of PSH in the standard group (1.0 %) and none in the GraNee Needle group. Conclusion No hernias were identified at any of the trocar sites when the GraNee Needle system was used. This method is quick, safe and provides adequate closure of the fascia and peritoneum which can be confirmed by intraperitoneal inspection.