Assessment of Port Site Complications in Laparoscopic Surgery â?? A Prospective Descriptive Study from Western Odisha

Abstract

Harekrishna Majhi1, Tapan Kumar Nayak2, Sheik Salman Raghib3, Anand Seba Tirkey4

BACKGROUND
Laparoscopic surgery has brought about a paradigm shift in modern surgical care.
It has varied applications in gastrointestinal surgery, urological surgery,
gynaecological surgery and oncosurgery. Better cosmesis, less post-operative
pain, hence reduced need for post-operative analgesia, shorter recovery period
and faster return to daily activities are its advantages. However, certain
complications like port site infection, hemorrhage, hernia, TB or metastasis are
morbid complications that undermine its benefits. In this study, we wanted to
identify the various port site complications in patients undergoing laparoscopic
surgery for different diseases in our hospital and assess its incidence.
METHODS
This is a prospective descriptive study. 125 patients admitted to the Department
of General Surgery from November 2018 to October 2020 who fulfilled the
inclusion and exclusion criteria underwent elective laparoscopic surgeries. They
were observed post-operatively for various port site complications. All the data
was entered into the Microsoft Excel 2007 software and further analysis was done
using SPSS software version 24.0 (IBM Inc. Chicago). A P - value of less than 0.05
was considered statistically significant.
RESULTS
Of 125 patients that underwent laparoscopic surgery, 9 patients (7.2 %)
developed complications specific to port site upon a follow-up of 3 months.
Complications observed were port site infection (n = 4, 3.2 %), port site
hemorrhage (n = 2, 1.6 %). Port site hernia, port site tuberculosis (TB), umblical
port site hernia and mild subcutaneous emphysema were observed in one patient
each (0.8 %). Scar abnormalitites were seen in 3 patients (2.4 %).
CONCLUSIONS
Laparoscopy is associated with minimal complications. However rare these
complications are, they take away from the advantages of the laparoscopic surgery
and the reputation of the hospital and surgeon alike. Apt patient selection,
meticulous surgical technique, proper sterilization of the laparoscopic instruments
and effective antibiotics use can further reduce the incidence of complications.
 

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