LAUSR

Abdominal wall closure guidelines recommend the utilization of slow absorption sutures. However, fast absorption sutures are still used for laparoscopic trocar site closure, mainly due to ease of handling and availability. We planned a retrospective cohort study, analysing the incidence of trocar site hernia (TSH) depending on the suture used for the fascial closure. A retrospective cohort study is carried out including a sample of 200 patients operated in our centre by any elective laparoscopic procedure, by Hasson access technique at the umbilical trocar site. Patients were distributed in 2 groups, according to the suture used: Group-1 Polyglactin, Group-2 Polydioxanone. In both groups the needle that was employed had a J-shape. Patients that had open or robotic surgery, reinterventions, and previous diagnosis of umbilical hernia were excluded. 100 patients were included in Group-1, and 100 patients in Group-2. The average age was 57.34 and 63.39 years respectively. The incidence of TSH in Group-1 was 20% with an average follow up of 22.3 months, compared to an 15% TSH incidence in Group-2, with an average follow-up of 20.3 months. These differences were not statistically significant. 80% of TSH were diagnosed in the first 24 months after the surgery. Likewise the existing evidence in open surgery wall closure, the use of slow absorption sutures in trocar site closure probably reduces the TSH incidence, without repercussion in comorbidity, however, in our study, the sample was not enough to prove statistical significance. These results should be contrasted with further randomized Control Trials.