How to Prevent Trocar-site Hernia? A Totally Atraumatic Endoscopic Mini-IPOM-Plug Technique (With Extra-Lightweight Titanium-coated Mesh and Glue).

Background: The trocar-site hernia is a new complication in laparoscopic surgery, which is becoming increasingly prevalent. Thus, the search for an efficient method of prophylaxis should be prioritized.

Materials And Methods: We describe a new, totally endoscopic technique based on 2 steps, intra-abdominal and parietal: (1) a mini-IPOM with an extra-lightweight titanium-coated mesh, fixed atraumatically using glue and (2) occlusion of the parietal opening using a small plug.

Results: In 15 cases, we have not needed to expand the initial aperture, performance time was always less than a minute, and we did not encounter any added morbidity, pain, local infection, or hernia, over a minimum postoperative follow-up period of 6 months.

Conclusions: Our technique for trocar-site closure is easy to perform, safe, and not time-consuming. A complete reconstruction is achieved of the peritoneal injury (intra-abdominal) and of the parietal route created by the trocar (intraparietal). The mesh design and fixation with glue are essential for good results.