Incisional Hernia After Midline Versus Transverse Extraction Incision in Laparoscopic Colectomy

Incisional Hernia After Midline Versus Transverse Extraction Incision in Laparoscopic Colectomy: A Pilot Randomized Trial

Incisional hernia (IH) is a common complication of midline laparotomy. Despite the hope that laparoscopic colon resection would result in fewer incisional hernias, prospective studies demonstrate a similar incidence to open surgery. Observational studies suggest that the rate of incisional hernia after laparoscopic colon resection may be reduced with the use of a transverse compared to a midline extraction incision. However, no randomized trails are available, and a midline extraction incision for hemicolectomy remains the standard current approach. The investigators hypothesize that the use of a lower abdominal transverse muscle splitting incision for specimen extraction in laparoscopic colon surgery will result in fewer incisional hernias compared to a midline periumbilical extraction incision.

Inclusion Criteria:

• scheduled laparoscopic partial colectomy where an abdominal extraction incision is planned

Exclusion Criteria:

• previous laparotomy
• rectal resection or anastamosis
• planned pfannenstiel extraction incision
• single site surgery
• planned or performed stoma
• BMI >35 kg/m2
• ASA 4-5