Supra-Umbilical 10 mm Port Site Management in Laparoscopic Cholecystectomy: Closure versus Non-Closure
DOI:
https://doi.org/10.37375/susj.v16i1.4161Keywords:
Laparoscopic cholecystectomy, Trocar, Fascial sheath closure, Port site hernia, Laparoscopic complicationsAbstract
Background: Port site complications, including port site hernia, bleeding, and infection, are uncommon but may depend on port size and location, trocar characteristics, patient-related factors, and surgeon experience. The necessity of routine fascial sheath closure for 10-mm supra-umbilical ports remains controversial. This study aimed to evaluate the outcomes of fascial sheath closure versus non-closure of the supra-umbilical 10-mm port site during laparoscopic cholecystectomy. Materials & Methods: This prospective comparative study included 72 patients who underwent laparoscopic cholecystectomy at Sirt Oncology Center and Ibn Sina Hospital, Libya, between August 2024 and February 2025. Patients were alternately allocated into two groups: Group A (fascial sheath closure using 0 Prolene with skin closure using 3/0 Prolene) and Group B (no fascial sheath closure, skin closure only with 3/0 Prolene). A sharp 10-mm trocar was inserted through the linea alba at the supra-umbilical port site. Patients were followed for 1–4 months for port site complications. Results: No cases of port site hernia, bleeding, or infection were recorded in either group during the follow-up period. The incidence of port site complications was 0% in both groups. Conclusion: Fascial sheath closure of 10-mm supra-umbilical port sites increases operative time and procedural cost and may carry a risk of inadvertent visceral or omental injury. In experienced hands, routine fascial sheath closure of 10-mm supra-umbilical ports may not be necessary. Larger randomized studies with longer follow-up are recommended to confirm these findings.
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