Assessment of Ports Site Complications in Laparoscopic Surgery

Abstract

Background: Laparoscopic surgery is a minimally access technique that has revolutionized the approach to surgery over the last three decades. It involves the use of reusable or disposable trocars and ports inserted through small skin incisions. Throughout the worldwide acceptance and success of laparoscopic surgical procedures; tremendous research activities have been taken place to invent safe, cost effective, fine and reliable laparoscopic instruments namely trocars and ports. These delicate tools have minimized the complications may occur during surgery.

Aims of the study: This prospective analytic study was designed to determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery. It has also emphasized the way of prevention of these complications and identified the risk factors causing these complications.

Patients and method: This is a prospective analytic study conducted at Al-Imam Al-Hussein medical city and Al-Safeer surgical hospital in Kerbala governorate during the period from 1^st of February to the 31^st of December 2019. In this series 220 patients included were admitted to the general surgical ward in these two hospitals for different laparoscopic procedures. Ports site were monitored for complications prospectively for 3 months. Those were converted to open procedures and those with immune compromised disease were excluded from the study.

Results: A series of 220 patients including 41(18.7%) males and 179(81.3%) females were operated. A total of 38 (17.27%) patients had ports site complications. Laparoscopic cholecystectomy was the most commonly performed procedure (71.8% n=158) with highest ports site complications (15% n=33). 28(12.7%) were due to ports site pain.12(5.4%) patients developed ports site infection. Five (2.2%) patients developed ports site heamatoma and two (0.9%) patients developed ports site bleeding. Ports site complications were common in the obese patients and increase with age and with increase ports numbers and sizes.

Conclusions: Ports site complications is important part of laparoscopic morbidity. Most of the complications are avoidable when using perfect surgical technics and skills. Ports site pain is the most frequent and important post-operative complications.