Higher incidence of trocar site hernia with gallbladder extraction via umbilical versus epigastric trocar port: a multicentre retrospective analysis of laparoscopic cholecystectomy.

Background: Trocar site hernia (TSH) is a known complication of laparoscopic cholecystectomy (LC). Gallbladder extraction is typically performed through the umbilical or epigastric trocar port. However, data on the incidence of TSH in relation to the extraction site is limited. This study aimed to evaluate the need for surgical repair of TSH following gallbladder extraction through the umbilical versus epigastric trocar port.

Methods: A retrospective cohort study was conducted across two Dutch general hospitals. It assessed the occurrence of TSH after LC and examined commonly described risk factors in relation to the TSH location.

Results: Among 2 377 patients that underwent LC, the extraction site of the gallbladder was known in 1756 patients. Gallbladder extraction was performed via the umbilical trocar port in 929 (53%) of cases and via the epigastric trocar port in 827 (47%) of cases. TSH repair was required in 36 (2.1%) patients, with a higher incidence in patients with gallbladder extraction through the umbilical trocar port (3.2%) compared to the epigastric trocar port (0.7%), (p < 0.001).

Conclusion: The need for operative repair of a TSH after a LC is significantly reduced when the gallbladder is retrieved through the epigastric trocar site port compared to the umbilical trocar site port.