The protective effect of body mass index in overweight patients with herniation through unclosed port of trocar: a randomized clinical trial

Background: The incidence of trocar site herniation differs in various studies. The incidence of these hernias is increased in patients who experience significant weight gain postoperatively. The aim of this study was to compare the complication of closed trocar port site with open port and effect of body mass index on the herniation using trocar site incision in laparoscopic surgery.Methods: In this prospective, randomized clinical, a total of 100 patients were scheduled to undergo appendectomy, cholecystectomy, ovarian cyst excision, herniorraphy and diagnostic laparoscopy at the Surgical Gastroenterology Service of The Baqiyatallah Hospital. Patients were randomly distributed into group OP (open port, n= 52) and group CP (closed port, n = 48). The follow up intervals were at 3 and 12 months after surgical operation Results: Five patients in OP group developed incision hernia. Regarding infection, hematoma, there was no significant difference between the two groups. Surprisingly, in OP group the average BMI (kg/m²) in herniated patients was significantly less than nonherniated cases.Conclusion: An important step to avoid post laparoscopic hernias is suturing the fascia whenever the trocar diameter exceeds 10 mm. If surgeons tend to have an open trocar site of 10 mm, particularly in facial defects; the trocar site is protected from incision hernia in obese patients with high BMI.