A Prospective Study of 200 Cases of Laparoscopically Operated Patients for Portsite Complications

Objective: To study the incidence of port site complications, complications related to different port size and port number in laparoscopically operated patients. Methods: The study was conducted in 200 patients operated laparoscopically in our hospital i. e. Sir Thakhtsinhji General Hospital, Bhavnagar during the period of JULY 2011 to JUNE 2013. Once the patient is selected, written and informed consent is obtained. They are then to be interviewed for detailed clinical history and subjected to investigations according to proforma. As per the Clinical judgment open and laparoscopic surgery is to be planned. Once the patient is treated by laparoscopic surgeries the patient will be examined for post-operative pain, infection and various other post-operative complications. Results: In my study 200 cases of laparoscopically operated were taken and followed for 6month after surgery. (single port appendicectomy 30, double port appendicectomy 26, more than two ports appendicectomy 76, laparoscopic hernioplasty 32, laparoscopic cholecystectomy 26, diagnostic laparoscopy 10. So single port site operated patients were 15 %, double port site operated patients were 18 % and three or more port site operated patient were 67 %). The average age of around 29 years. There were 54 % male& 46 % female in the study. Early complications (At 1 months): Early port site pain is more common in laparoscopic cholecystectomy 20/26 (76 %) than in single port appendicectomy 3/30 (10 %), in double port appendicectomy 5/26 (19 %), in three ports 26/76 (34 %), with laparoscopic hernioplasty 14/32 (43 %), with diagnostic laparoscopy 2/10 (20 %). The incidence rate of immediate post-operative complications according to port site number were 10 % port site pain in single port site surgery, 19 % in two port site surgery and 45 % in three port site surgery. The incidence rate of immediate port site pain appears to be 36 % in 10 mm ports compared to 7 % in 5 mm ports. Port site seroma was seen in three port lap appendicectomy in 2/76 patients (2.63 %). The incidence rate of port site seroma was 0.4 % in 10 mm ports compared to 0.3 % in 5 mm ports. Infections at port site were seen in three port appendicectomy in 1/76 patient (1.31 %) and with laparoscopic cholecystectomy 1/26 patient (4 %). The incidence rate of port site infection was 0.8 % in 10 mm ports, while no infection in 5 mm ports. Late Complications (At 6 Months): Port site hernia in laparoscopic cholecystectomy 1 (4 %) in epigastric region. The incidence rate of port site hernia appeared to be 0.4 % in 10 mm port site compared to no hernia in 5 mm ports. No other complication was noted. Summary& conclusions: The overall port site complications rate were very low in all laparoscopically operated patients. The early and late complications like port site pain, port site seroma, port site infection, port site hernia occurred in single port site laparoscopic surgery were very low compared to two or more port site laparoscopic surgery. So single port site laparoscopic surgery and small size of port were better outcome than others. It is advisable to decrease the size of port and number of port site, which would decrease complications and discomforts to the patient.