A review of the incidence of iatrogenic hernia in both laparoscopic and open colorectal surgery: Using CT as the gold standard of detection, cohort study

PURPOSE: The incidence of incisional hernia varies considerably in the literature. The aim of our study was to calculate the incidence of various types of the occult iatrogenic hernias following colorectal surgery, both laparoscopic and open, using CT scan. METHODS: The study included all patients who underwent colorectal resection procedures in a colorectal surgery department over an 11 year period between 2001 and 2012 who went on to have a CT scan post surgery. The term iatrogenic hernia included all postoperative hernias at laparotomy incision site in the open colorectal subgroup, hernias at the site of specimen extraction or port site hernias in the laparoscopic colorectal subgroup, and parastomal hernias in both subgroups. RESULTS: The total number of diagnosed iatrogenic hernias was 74 (61 detected on CT scan and 13 repaired on clinical grounds). Out of the 74 diagnosed iatrogenic hernias, 23 (31.1%) required surgical repair; 11 in the LCR (6 incisional, 2 parastomal and 2 port site hernias) and 12 in the OCR (9 incisional and 3 parastomal). CONCLUSION: The incidence of iatrogenic hernias is underestimated. The use of CT will increase the number detected. There is no significant difference in the incidence of iatrogenic hernias between laparoscopic and open colorectal procedures.