SILS Incisional Hernia Study

Harvey C Rainville, MD, Diego Camacho, MD, Jenny Choi, MD, Emmanuel Agaba, MD, Pratibha Vemulapali, MD. Montefiore Medical Center

Introduction
Over the past several years single incision laparoscopic surgery (SILS) has become increasingly popular. SILS includes incorporation of multiple abdominal trocars into one fascial defect, often at the umbilicus. The potential for incisional hernias after insertion of trocars is a well known postoperative complication. However, the hernia rates after SILS procedures is largely unknown. We were interested in evaluating the incidence of postoperative incisional hernias after a SILS operation.

Methods
We conducted a single institution retrospective study of over 200 patients who underwent any type of general surgery SILS procedure over two years. These primarily included appendectomies, cholecystectomies, partial gastrectomies, and partial colectomies. Some of these operations included insertion of multiple trocars into one skin incision, while the majority consisted of a single 2 cm fascial defect at the umbilicus repaired primarily. A history and physical exam was performed on all patients at a mean follow up of six months to 24 months to evaluate for the presence of an incisional hernia at the SILS port site.

Results
6 patients had umbilical hernias that need to be operatively repaired, 2 patients had small defects that refused repair and 4 others complained of pain without a fascial defect palpated on exam.

Conclusion
Post-operative hernias after SILS procedures did occur, but the incidence is no greater than other laparoscopic procedures.