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CC BY 4.0 · Surg J (N Y) 2021; 07(03): e168-e171
DOI: 10.1055/s-0041-1731270
Original Article

The “Flip-Flap” Technique for Laparoscopic Port-Site Closure—Description of a Novel, Cost-Effective Technique with Review of Literature

Ajaz Ahmed Wani 
1   Department of Surgical Gastroenterology, Shri Mata Vaishno Devi Narayana Superspecialty Hospital, Kakryal, Katra, Jammu and Kashmir, India
,
Suhail Khuroo 
1   Department of Surgical Gastroenterology, Shri Mata Vaishno Devi Narayana Superspecialty Hospital, Kakryal, Katra, Jammu and Kashmir, India
,
Saurabh Kumar Jain 
2   Department of Clinical Associate Surgical Gastroenterology, Action Cancer Hospital, New Delhi, India
,
Vikas Kumar Heer 
3   Department of Surgical Oncology, Shri Mata Vaishno Devi Narayana Superspecialty Hospital, Kakryal, Katra, Jammu and Kashmir, India
,
Deepak Rajput 
4   Department of General Surgery, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
,
Shadab Maqsood
5   Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Abstract

Overview Laparoscopic approach has changed the face of surgical care offered to patients. Almost all surgical procedures across specialties are now undertaken by the laparoscopic approach. Closure of port sites to prevent trocar-site hernias (TSHs) forms an integral part of the laparoscopic procedure. TSH is an area of preventable surgical morbidity. We hereby report our technique that is easily applicable, simple, safe, and highly cost-effective. It requires no additional instruments or retractors, is easy to learn, and has a very favorable safety profile.

Materials and Methods This prospective case series enrolled a total of 454 port-site closures in 255 patients undergoing different laparoscopic procedures over a period of 2 years. The intraperitoneal tissue forceps were used in the reverse direction to lift the fascia up and a right-angled retractor was used to retract back the skin and subcutaneous tissue. The port-site closure is done under vision and no adverse events were reported.

Results This technique was used in 454 port sites in 255 patients. No intraoperative incidents were noted. There is no requirement of any specialized instruments or retractors. No additional tissue trauma or dissection is required. There is no extension of operative time. The technique is simple to learn and easy to teach. No bowel injuries or TSHs were reported during a follow-up of 26 months.

Conclusion The described technique is easy, simple, cost-effective, and has a good safety profile.

Keywords

port-site hernia - trocar-site hernia - special type of hernia

Note

All patients gave adequate written authorization for their enrollment in the study and adequate institutional approval was taken.




Publication History

Received: 21 October 2020

Accepted: 09 April 2021

Article published online:
19 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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