Il laparocele su "trocar site" in chirurgia laparoscopica

The main aim of this study was to evaluate the incidence of incisional hernia at the trocar site, as well as to contribute towards definig the aetiopathogenetic factors responsible. One hundred and fitfty cases of patients undergoing laparoscopic surgery were studied retrospectively from the clinical and ultrasonographical point of view. The laparoscopic gaps examined numbered approximately 600 in all. The incidence of incisional hernia was 2%, exclusively located in the periumbelical area. There were no incisional hernias in extraumbelical areas, which we usually do not suture. A symptomatic extraumbilical hernia occurred at a 5 mm site in a patient previously operated on in another hospitala. Particular attention needs to be paid to periumbilical gap suture, exposed to the trauma of the trocar fixing, expecially in obese and diabetic patients. In selected cases the other gaps should be sutured, including the 5 mm ones.