Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation

The incidence of trocar orifice eventrations (EOT) is very varied in the different series analyzed and there are no clear recommendations on its prevention. This motivated us to conduct a multicenter study involving general surgery residents with experience in laparoscopic cholecystectomy belonging...

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Autores principales: Garcias , L, Vélez, S
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023
Materias:
hernia
Cholécystectomie laparoscopique
trocar
colecistectomía laparoscópica
TROCAR
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/42777
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-42777
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic hernia
Cholécystectomie laparoscopique
trocar
hernia
colecistectomía laparoscópica
TROCAR
spellingShingle hernia
Cholécystectomie laparoscopique
trocar
hernia
colecistectomía laparoscópica
TROCAR
Garcias , L
Vélez, S
Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
topic_facet hernia
Cholécystectomie laparoscopique
trocar
hernia
colecistectomía laparoscópica
TROCAR
author Garcias , L
Vélez, S
author_facet Garcias , L
Vélez, S
author_sort Garcias , L
title Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
title_short Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
title_full Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
title_fullStr Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
title_full_unstemmed Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
title_sort eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation
description The incidence of trocar orifice eventrations (EOT) is very varied in the different series analyzed and there are no clear recommendations on its prevention. This motivated us to conduct a multicenter study involving general surgery residents with experience in laparoscopic cholecystectomy belonging to eleven national and international training centers. The aim of this study was to evaluate incidences of EOT, risk factors associated with EOT and to develop recommendations to reduce the incidence of EOT. A retrospective, observational study was conducted with a prospective database in which 900 patients underwent laparoscopic cholecystectomy. More than sixty surgeons in training participated, belonging to ten national public training centers and a training center belonging to the Republic of Peru, also public. The overall EOT incidence in this study was 3%, follow-up was on average 10 months, slightly higher than that reported in the literature by trained surgeons.The institutions that presented this complication with low incidence were those that carried out the systematic closure of both holes of 10 mm. Currently, EOT is still a frequent complication, but there is no significant difference in incidence between this peer-reviewed resident analysis and studies performed in specialist surgeons. Having found that the non-modifiable factors of the patient play an important role in this series, we conclude that all orifices of 10 mm or greater should be closed with non-resorbible or late resorption material, including as far as possible all layers of the abdominal wall, since not only the diameter of trocar will determine or not the risk of eventracion.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2023
url https://revistas.unc.edu.ar/index.php/med/article/view/42777
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AT garciasl eventracionenlospuertosdelostrocaresencolecistectomialaparoscopicaporcirujanosenformacion
AT velezs eventracionenlospuertosdelostrocaresencolecistectomialaparoscopicaporcirujanosenformacion
first_indexed 2024-09-03T21:04:58Z
last_indexed 2024-09-03T21:04:58Z
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spelling I10-R327-article-427772023-10-19T21:19:19Z Eventracion of trocar ports in laparoscopic cholecystectomy by surgeons in formation Eventración en los puertos de los trócares en colecistectomía laparoscópica por cirujanos en formación Garcias , L Vélez, S hernia Cholécystectomie laparoscopique trocar hernia colecistectomía laparoscópica TROCAR The incidence of trocar orifice eventrations (EOT) is very varied in the different series analyzed and there are no clear recommendations on its prevention. This motivated us to conduct a multicenter study involving general surgery residents with experience in laparoscopic cholecystectomy belonging to eleven national and international training centers. The aim of this study was to evaluate incidences of EOT, risk factors associated with EOT and to develop recommendations to reduce the incidence of EOT. A retrospective, observational study was conducted with a prospective database in which 900 patients underwent laparoscopic cholecystectomy. More than sixty surgeons in training participated, belonging to ten national public training centers and a training center belonging to the Republic of Peru, also public. The overall EOT incidence in this study was 3%, follow-up was on average 10 months, slightly higher than that reported in the literature by trained surgeons.The institutions that presented this complication with low incidence were those that carried out the systematic closure of both holes of 10 mm. Currently, EOT is still a frequent complication, but there is no significant difference in incidence between this peer-reviewed resident analysis and studies performed in specialist surgeons. Having found that the non-modifiable factors of the patient play an important role in this series, we conclude that all orifices of 10 mm or greater should be closed with non-resorbible or late resorption material, including as far as possible all layers of the abdominal wall, since not only the diameter of trocar will determine or not the risk of eventracion. La incidencia de eventraciones de los orificios de los trócares (EOT) es muy variada en las distintas series analizadas y no existen recomendaciones claras sobre su prevención. Esto nos motivó a realizar un estudio multicéntrico donde participaron residentes de cirugía general con experiencia en colecistectomía laparoscópica pertenecientes a once centros formadores nacionales e internacionales. El objetivo de este estudio es evaluar incidecia de EOT, factores de riesgo asociados a EOT y desarrollar recomendaciones para disminuir la incidencia de EOT. Se realizó un estudio retrospectivo, observacional con base de datos prospectiva donde se analizaron 900 pacientes intervenidos de colecistectomía laparoscópica. Participaron más de sesenta cirujanos en formación, pertenecientes a diez centros formadores públicos nacionales y un centro formativo perteneciente a la Republica del Perú, también público. La incidencia EOT general en este estudio fue del 3%, el seguimiento fue en promedio 10 meses, levemente superior a la reportada en la literatura por cirujanos formados. Las instituciones que presentaron esta complicación con baja incidencia fueron las que efectúan el cierre sistemático de ambos orificios de 10 mm. En la actualidad las EOT siguen siendo una complicación frecuente, pero sin diferencias significativas de incidencia entre este análisis de residentes tutorizados y los estudios realizados en cirujanos especialistas. Habiendo objetivado que los factores no modificables del paciente presentan un rol importante en esta serie, concluimos que todos los orificios de 10 mm o mayores deben ser cerrados con material no reabsorbible o de reabsorción tardía, incluyendo en lo posible todas las capas de la pared abdominal, ya que no solo el diámetro de trócar determinará o no el riego de eventración. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42777 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42777/42812 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

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