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High incidence of trocar site hernia after laparoscopic or robotic Roux-en-Y gastric bypass

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Abstract

Background

Trocar Site Hernia (TSH) seems to represent a rare surgical complication, but available data are based only on symptomatic patients and clinically diagnosed cases; moreover, no data are available concerning TSH incidence after robotic-assisted procedures. Aims of the study were to asses TSH incidence in obese patients who underwent Roux-en-Y gastric bypass (RYGB) and to compare it between robotic-assisted and standard laparoscopy.

Methods

Patients who underwent RYGB between November 2007 and June 2012 underwent a clinical examination and an ultrasonography study of the abdominal wall by a single operator.

Results

150 patients entered the study, 102 in the laparoscopic and 48 in the robotic group. Mean pre-operative weight and BMI were 129.3 kg and 47.4 kg/m2, respectively; both were higher in the laparoscopic group (134.7 vs 117.6 kg, p < 0.001; 49.2 vs 43.8 kg/m2, p < 0.001), while pre-operative comorbidities were not significantly different between groups. Operative time was lower in the laparoscopic group (182.7 vs 284.0 min, p < 0.001), while post-operative complications were not different between groups. The overall incidence of TSH was 39.3 % (59/150); incidence was 35.3 % (36/102) in the laparoscopic and 47.9 % (23/48) in the robotic group (p = 0.195). There were no significant differences between patients with and without TSH, except for higher post-operative wound complication in patients without TSH (22 vs 6.8 %, p = 0.024; OR 0.26).

Conclusions

TSH revealed a high incidence in a bariatric surgery population, suggesting that it represents a strongly underestimated complication; furthermore, the present study showed a trend towards a higher incidence of TSH in patients who underwent robotic-assisted bariatric surgery.

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Disclosures

Gitana Scozzari, Marcello Zanini, Francesca Cravero, Roberto Passera, Fabrizio Rebecchi and Mario Morino have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Surgical Sciences, University of Torino, C.so AM Dogliotti, 14, 10126, Torino, Italy

    Gitana Scozzari, Marcello Zanini, Francesca Cravero, Fabrizio Rebecchi & Mario Morino

  2. Division of Nuclear Medicine, AOU Città della Salute e della Scienza and University of Torino, Torino, Italy

    Roberto Passera

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  1. Gitana Scozzari
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Correspondence to Mario Morino.

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Scozzari, G., Zanini, M., Cravero, F. et al. High incidence of trocar site hernia after laparoscopic or robotic Roux-en-Y gastric bypass. Surg Endosc 28, 2890–2898 (2014). https://doi.org/10.1007/s00464-014-3543-5

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