Laparoscopic Cholecystectomy; closure versus non-closure of the fascial sheath opening of the sub-umbilical port site “10 mm”.

Background: Laparoscopic Surgery (LS) may be associated with many port site complications such as hernia, bleeding, infection, subcutaneous emphysema and ugly scars. Some of these complications are serious such as obstructed port site hernia . Rate of these complications is low depending  on size and site of the port incision, type of the trocar that it is used, the condition of  the patient and  experience of the surgeon. Many surgeons prefer to close the port site fascial sheath defects of 10 ,12 and 15 millimeters (mm) port in diameter leaving  port site fascial defect of 5 mm without closure. Other surgeons do not close port site fascial sheath defects of 5mm and 10mm due to : rarity of occurrence of hernia in these two port site fascial defects, to shorten the operative time ,to reduce use of sutures  and to avoid complications of suturing such as incidental entrapment of the abdominal viscera with suture of the port site fascial defect . Patients & Methods: This a prospective study was carried out in AL-Karama Teaching Hospital/ Department of Surgery/College of Medicine/Wassit University/IRAQ from September 2017 to January 2018 in laparoscopic unit by different specialized laparoscopic surgeons. A total number of 50 patients were enrolled in this study. Patients were alternatively divided into two groups: Group A : the sub-umbilical port site fascial defect of 10mm in diameter was closed with Zero Nylon  (Dynek Pty Ltd,Ausralia)  in addition to skin closure with Zero Silk (DemeTECH/USA)  .