Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation

Abstract

The incidence of trocar orifice eventrations (EOT) is very varied in the different series analyzed and there are no clear recommendations on its prevention. This motivated us to conduct a multicenter study involving general surgery residents with experience in laparoscopic cholecystectomy belonging to eleven national and international training centers. The aim of this study was to evaluate incidences of EOT, risk factors associated with EOT and to develop recommendations to reduce the incidence of EOT.

A retrospective, observational study was conducted with a prospective database in which 900 patients underwent laparoscopic cholecystectomy. More than sixty surgeons in training participated, belonging to ten national public training centers and a training center belonging to the Republic of Peru, also public.

The overall EOT incidence in this study was 3%, follow-up was on average 10 months, slightly higher than that reported in the literature by trained surgeons.The institutions that presented this complication with low incidence were those that carried out the systematic closure of both holes of 10 mm.

Currently, EOT is still a frequent complication, but there is no significant difference in incidence between this peer-reviewed resident analysis and studies performed in specialist surgeons. Having found that the non-modifiable factors of the patient play an important role in this series, we conclude that all orifices of 10 mm or greater should be closed with non-resorbible or late resorption material, including as far as possible all layers of the abdominal wall, since not only the diameter of trocar will determine or not the risk of eventracion.