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How to Prevent Trocar-site Hernia? A Totally Atraumatic Endoscopic Mini-IPOM-Plug Technique (With Extra-Lightweight Titanium-coated Mesh and Glue)

Moreno-Egea, Alfredo MD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2015 - Volume 25 - Issue 3 - p e106–e108
doi: 10.1097/SLE.0000000000000153
Online Articles: Technical Reports

Background: The trocar-site hernia is a new complication in laparoscopic surgery, which is becoming increasingly prevalent. Thus, the search for an efficient method of prophylaxis should be prioritized.

Materials and Methods: We describe a new, totally endoscopic technique based on 2 steps, intra-abdominal and parietal: (1) a mini-IPOM with an extra-lightweight titanium-coated mesh, fixed atraumatically using glue and (2) occlusion of the parietal opening using a small plug.

Results: In 15 cases, we have not needed to expand the initial aperture, performance time was always less than a minute, and we did not encounter any added morbidity, pain, local infection, or hernia, over a minimum postoperative follow-up period of 6 months.

Conclusions: Our technique for trocar-site closure is easy to perform, safe, and not time-consuming. A complete reconstruction is achieved of the peritoneal injury (intra-abdominal) and of the parietal route created by the trocar (intraparietal). The mesh design and fixation with glue are essential for good results.

Morales Meseguer Universitary Hospital, Murcia, Spain

The author declares no conflicts of interest.

Reprints: Alfredo Moreno-Egea, MD, Morales Meseguer Universitary Hospital, Murcia, 30008, Spain (e-mail:

Received September 17, 2014

Accepted March 2, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.