Trocar-site hernia as a typical postoperative complication of minimally invasive surgery among preschool children

Surg Endosc. 2008 Dec;22(12):2724-7. doi: 10.1007/s00464-008-9768-4. Epub 2008 Feb 13.

Abstract

Background: Minimally invasive surgery (MIS) in preschool children (<5 years of age) is not common yet, and few reports evaluating typical complications are available. Trocar site hernias are well described in adult patients but also have been reported for preschool children. The goal of our study was to determine incidence and relevance of trocar site hernias as complications of minimally invasive surgery in preschool children.

Methods: Retrospective analysis of all pediatric patients who underwent minimally invasive surgery at a single institution. Review of the literature.

Results: Trocar site hernias are significantly more frequent in preschool children than in older ones (p = 0.006). Complication rates at all are not significantly different. Trocar site hernias in infants are mainly of type 3 (omental protrusion) and occur within the first postoperative week.

Conclusion: Meticulous suturing of all layers (particularly the peritoneum) even in small incisions (2 mm) is recommended to prevent omental protrusion at trocar site in children up to 5 years of age.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Abscess / epidemiology
  • Abdominal Abscess / etiology
  • Adolescent
  • Age Factors
  • Child, Preschool
  • Female
  • Hernia, Ventral / epidemiology
  • Hernia, Ventral / etiology*
  • Hernia, Ventral / prevention & control
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Male
  • Omentum
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Punctures / adverse effects*
  • Punctures / instrumentation
  • Retrospective Studies
  • Surgical Instruments
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Suture Techniques