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Incidence of Port-Site Hernias

A Survey and Literature Review

Holihan, Julie L. MD; Chen, Jeffery S. MD; Greenberg, James MD; Hehir, Dermot MD; Johnston, Sean M. MD; Marcus, Daniel MD; Ryan, Heidi MD; Tsuda, Shawn MD; Liang, Mike K. MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: December 2016 - Volume 26 - Issue 6 - p 425–430
doi: 10.1097/SLE.0000000000000341
Review Articles
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Background: The impact of laparoscopy on the prevalence of incisional hernias remains unclear. The aim of this study is to determine (1) surgeon perceptions of port-site hernias (PSHs), (2) the true incidence of PSH.

Materials and Methods: A survey on PSH was given to determine the surgeon-reported rate of PSH. A literature review was performed for studies with a primary outcome of PSH. Studies were evaluated using checklists, and scores were used to compare risk of bias. Risk of bias was graphed against PSH incidence.

Results: From 38 surgeons surveyed, the surgeon perceived rate of PSH was a median (range) of 0.5% (0% to 5%) for ports ≤5 mm, 5% (0.1% to 20%) for ports extended, and 5% (0.1% to 40%) for ports ≥10 mm. Thirty studies showed a PSH rate from 0% to 39.3%. Higher quality studies reported higher rates of PSH.

Conclusions: Surgeons underestimate the incidence of PSH, but high-quality literature suggests that it may be nearly 40%.

*Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX

Department of Gynecology, Harvard Medical School, Boston, MA

§Department of Surgery, Marina Del Rey Hospital, Los Angeles, CA

Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nevada

Department of Surgery, Midland Regional Hospital, Westmeath, Ireland

J.L.H., J.S.C., J.G., D.H., and M.K.L. have no conflicts of interest or financial ties to disclose. S.M.J. received payment for consultancy from Neosurgical. D.M. received payment from Medtronics and Gore. S.T. received travel support from Enterprise Ireland and Acelity, payment for lectures/speaking from Acelity, and payment for teaching from Intuitive. H.R. received travel support from Enterprise Ireland and Acelity, payment for lectures/speaking from Acelity, and payment for teaching from Intuitive.

Reprints: Julie L. Holihan, MD, 6431 Fannin St, MSB 5.254, Houston, TX 77030 (e-mail: Julie.L.Holihan@uth.tmc.edu, holihanj@gmail.com).

Received May 3, 2016

Accepted September 29, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.