OC-031 TROCAR SITE INCISIONAL HERNIA PREVENTION BY ONLAY MESH PLACEMENT, NOT WHAT WAS EXPECTED

Abstract

The prevalence of Trocar site incisional hernia (TSIH) might be as high as 30%, due to this reason is paramount to find a better closure technique. Our aim is to test the TSIH preventive effect of the placement of an onlay mesh versus the standard fascial closure at the umbilical trocar site closure.We designed a Two-Center Randomized Controlled Trial where adult participants presenting for elective laparoscopic cholecystectomy, were allocated into 2 groups (Prosthesis and Control). The Hasson technique was the pneumoperitoneum creation technique. The procedure in the Prosthesis group consisted in the complete closure of the umbilical vertical section of the aponeurosis by single 0 Polydioxanone stitches, a 2cm onlay plane dissection, the placement of a lightweight, large-pore synthetic mesh and its fixation applying cyanoacrylate glue, subcutaneous stitches, and skin staplers. The Control group aponeurosis was closed by single stitches of Polydioxanone followed by skin staplers.An ultrasound scan was performed at 12 postoperative months.At 12-month control, a 41.7% incidence of TSIH was recorded in the Prosthesis group while 28.5% in the control group. 6 patients developed a superficial wound infection at the umbilical port site in the Prosthesis group, and none in the Control group. 5 of the patients had to be operated for mesh removal as they developed 4 chronic infections and 1 seroma with bad wound pain control.The preliminary results of the study show no benefit in the Prosthesis group for the prevention of TSIH and presented with a greater number of complications.