Mind the gap: pre-operative diastasis recti increases trocar site hernia risk after laparoscopic cholecystectomy
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Sarah Lund
- Maxwell Mirande
- Cecilia Mitchell
- Clark Zheng
- Sanjna Rajput
- Erica Loomis
- Stephanie Heller
- Henry Schiller
- Daniel Stephens
- Mariela Rivera
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
Trocar site hernias impact 1–10% of patients undergoing a laparoscopic cholecystectomy, typically at the 10 mm port site. Risk factors identified for trocar site hernias include obesity and age; however, little is known about the impact of pre-existing diastasis rectus abdominus (DRA) on trocar site hernia rates. Therefore, we aimed to determine the impact of pre-operative DRA on trocar site hernia rates after laparoscopic cholecystectomy.
Methods
We conducted a retrospective review of patients undergoing a laparoscopic cholecystectomy for benign gallbladder disease at a single institution from January 2010 to May 2020. CT scan review was used to determine the presence of pre-operative DRA and to diagnose trocar site hernia. Logistic regression was used to determine the factors associated with development of a trocar site hernia.
Results
Of the 2,460 patients who underwent a laparoscopic cholecystectomy, 545 (22%) had both a pre- and post-operative CT scan and were included in analysis, with a 1.5 year median length of follow-up. Overall, 434 patients (80%) had pre-operative DRA and 88 patients (16%) developed a trocar site hernia. On logistic regression, presence of DRA was significantly associated with development of a trocar site hernia (OR = 4.12, 95% CI=[1.72,12.24], p = 0.004), while controlling for location of 10 mm port, BMI, age, sex, ASA classification, smoking status, whether surgery was elective, and presence of pre-operative umbilical hernia.
Conclusions
Radiologic diagnosis of both DRA and a trocar site hernia is highly prevalent within patients who undergo a laparoscopic cholecystectomy. Further, the presence of pre-operative DRA is significantly associated with development of a trocar site hernia after laparoscopic cholecystectomy.
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- Titel
- Mind the gap: pre-operative diastasis recti increases trocar site hernia risk after laparoscopic cholecystectomy
- Verfasst von
-
Sarah Lund
Maxwell Mirande
Cecilia Mitchell
Clark Zheng
Sanjna Rajput
Erica Loomis
Stephanie Heller
Henry Schiller
Daniel Stephens
Mariela Rivera
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03302-1
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