Eid George M, Collins Joy
Division of Minimally Invasive Surgery, the University of Pittsburgh Medical Center, PA, USA.
Obes Surg. 2005 Jun-Jul;15(6):871-3. doi: 10.1381/0960892054222623.
Herniation into the trocar-site is a relatively common complication of laparoscopic surgery, and represents a serious cause of morbidity because of the potential to develop into a Richter's hernia. The risk of trocar-site herniation is greater in obese and bariatric patients, because of the larger preperitoneal space and elevated intra-abdominal pressure; thus, fascial closure alone is not adequate. Full-thickness trocar-wound closure can prevent this complication. However, hand suturing and some port-closure devices can be difficult to use in this patient group. We report on the use of a specialized trocar wound closure system designed for use on obese and bariatric patients. In this report, we describe use of the system in the case of a 34-year-old Caucasian female who underwent a laparoscopic Roux-en-Y gastric bypass procedure.
穿刺孔部位疝是腹腔镜手术相对常见的并发症，由于有可能发展为里脱氏疝，它是一种严重的发病原因。肥胖和肥胖症患者发生穿刺孔部位疝的风险更高，因为腹膜前间隙更大且腹内压升高；因此，仅进行筋膜闭合是不够的。全层穿刺孔伤口闭合可预防此并发症。然而，手工缝合和一些端口闭合装置在该患者群体中可能难以使用。我们报告了一种专为肥胖和肥胖症患者设计的专用穿刺孔伤口闭合系统的使用情况。在本报告中，我们描述了该系统在一名34岁白种女性接受腹腔镜Roux-en-Y胃旁路手术病例中的应用。
