Anatomical closure of trocar site by using tip hole needle and redirecting suture hook

Background The incidence of trocar site incisional hernia following laparoscopic surgery is reported to be relatively high. The main reasons are trocar diameter and design, preexisting fascial defects, and some operation- and patient-related factors. The goal of this article is to present a new procedure for anatomical closure of the trocar site to prevent its herniation. Methods In this study, 120 patients underwent laparoscopic cholecystectomy from June 2006 through February 2009 at the General Surgery Department, Zagazig University Hospital, Egypt. After the laparoscopic procedure was complete, the trocar sites were closed in anatomical layers by using a tip hole needle and a redirecting suture hook. The mean follow-up period was 2 years for any complication at these trocar sites. Results The mean hospital stay was 1.2 days, the mean age of the patients was 49.4 years, and the mean time to place one suture was 5 min. No trocar site hernia occurred with this technique during a mean follow-up of 2 years. Seven patients developed superficial infection at the trocar site and no mortality was reported. Conclusion Good closure of the trocar site in layers by using a tip hole needle and a redirecting suture hook will prevent trocar site herniation.