Aziz Homayara Haque
Department of Gynecology and Obstetrics, State University of New York, University at Buffalo, Buffalo, NY, USA; Millard Fillmore Suburban Hospital Kaleida Health, Buffalo, NY, USA; Department of Obstetrics and Gynecology, University of Maryland, Baltimore Washington Medical Center, 7556 Teague Rd Suite 430, Hanover MD 21076, USA.
JSLS. 2013 Oct-Dec;17(4):672-4. doi: 10.4293/108680813X13794522666482.
Laparoscopic and robotic surgery is widely practiced in modern medicine. The operative procedure is not complete until the port sites are closed with a fascial suture. We report a simple new technique that is easy, cost-effective, and quick to apply using 2 S-retractors for suture placement under direct visualization to secure the abdominal wall fascia and peritoneum.
As a prospective consecutive case series, this technique was used for fascial closure after laparoscopy ports > 8 mm using 2 S-retractors. One S-retractor is used as a barrier protecting the contents of the abdominal cavity, reducing the risk of visceral injuries. The second S-retractor allows us to directly visualize the different layers, exposing the needle tip during its course through the fascia.
This method was used in 100 patients with no intraoperative incidents, additional operative time, or need to access costly instruments. Currently, this technique is also used by many surgeons in our institution without any difficulty. No bowel injuries or port-site hernias were reported during a mean follow-up of 6 wk postoperation and 12-mo annual follow-up.
The procedure is simple, easy, cost-effective, and quick to apply.