OPTIMIZATION OF LAPAROSCOPIC ACCESSES FOR REDUCTION OF POSTOPERATIVE WOUND COMPLICATIONS

Abstract

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Aim. To identify surgical accesses for laparoscopic cholecystectomy which are associated with less risk of postoperative wound complications. Material and Methods. The performed analysis of 180 clinical cases of the wound healing process after laparoscopic cholecystectomy showed that there are certain areas on the abdominal wall which are safer in terms of the development of complications. The anatomical features of epigastric and paraumbilical regions which are most commonly used for trocar accesses differ. One of the significant differences is the density of lymphatic vessels in these anatomical zones. Infiltrates and suppuration, and subsequently postoperative hernias are more often observed in paraumbilical region. Results and Discussion. Analysis of infectious complications in the field of surgical interventions showed that suppuration occurred in 11.7% patients (n=11) who underwent perianopic access for laparoscopic cholecystectomy in a container (total 94 patients), and only in 4.7% patients (n=4) after epigastric laparoscopic accesses (total 86 patients). Conclusions. The epigastric region is anatomically more preferable for laparoscopic surgical access in terms of lower risk of postoperative wound complications.