{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:17:35Z","timestamp":1787023055167,"version":"build-2736575974"},"reference-count":32,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"abstract":"<jats:p>ABSTRACT BACKGROUND: Incisional hernia is characterized by a bulging of the abdominal wall caused by the prolapse of intracavitary structures, such as a segment of the small intestine, through the trocar orifice. Ultrasonography and physical examination are used in the diagnosis of incisional hernia. AIMS: This study aimed to evaluate the difference between physical examination and abdominal ultrasonography at the diagnosis of incisional hernia in patients who underwent laparoscopic bariatric surgery. METHODS: A total of 123 patients who underwent Roux-en-Y gastric bypass type bariatric surgery performed by laparoscopy were analyzed for the presence or absence of hernia by physical and ultrasonography examination at each trocar incision site. RESULTS: In our results, a total of 7 hernias were detected by physical examination, while ultrasonography detected a total of 56 hernias in at least one of the incision sites. Lin's concordance analysis showed that the tests are not concordant. The association between body mass index and hernia detection (p=0.04 for physical examination and p=0.052 for ultrasonography) was observed. Ultrasonography detected more incisional hernias in 10-mm or larger trocars than in 5-mm trocars (p&lt;0.0001, p&lt;0.05). No differences were noted among the trocar types that were used. CONCLUSIONS: Abdominal ultrasonography showed to have a higher accuracy than physical examination, resulting in a substantial increase in incisional hernia detection at the trocar sites.<\/jats:p>","DOI":"10.1590\/0102-672020220002e1673","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T16:30:30Z","timestamp":1662741030000},"source":"Crossref","is-referenced-by-count":7,"title":["INCISIONAL HERNIA AFTER BARIATRIC SURGERY: ONLY THE PHYSICAL EXAMINATION IS ENOUGH?"],"prefix":"10.1590","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8870-7534","authenticated-orcid":false,"given":"Felipe Martin Bianco","family":"Rossi","sequence":"first","affiliation":[{"name":"RR Surgeons, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3428-6364","authenticated-orcid":false,"given":"Ricardo","family":"Moreno","sequence":"additional","affiliation":[{"name":"RR Surgeons, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1549-4336","authenticated-orcid":false,"given":"Amarilys Luiza","family":"Druziani","sequence":"additional","affiliation":[{"name":"Universidade S\u00e3o Caetano do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-6422","authenticated-orcid":false,"given":"Matheus Moreira","family":"Perez","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio Faculdade de Medicina do ABC, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4298-0265","authenticated-orcid":false,"given":"Eduardo","family":"Possari","sequence":"additional","affiliation":[{"name":"CDB Diagnostic Medicine, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1944-0324","authenticated-orcid":false,"given":"Renato Barretto","family":"Ferreira Da-Silva","sequence":"additional","affiliation":[{"name":"RR Surgeons, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3046-3201","authenticated-orcid":false,"given":"Mar\u00e7al","family":"Rossi","sequence":"additional","affiliation":[{"name":"RR Surgeons, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2022]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s10029-011-0865-2","article-title":"Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study","volume":"16","author":"Bloemen A","year":"2012","journal-title":"Hernia"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s10029-004-0270-1","article-title":"A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair","volume":"9","author":"Chan G","year":"2005","journal-title":"Hernia"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1381\/096089204322917954","article-title":"Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years","volume":"14","author":"Chevallier JM","year":"2004","journal-title":"Obes Surg"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.urology.2009.08.025","article-title":"Port-site hernias occurring after the use of bladeless radially expanding trocars","volume":"75","author":"Chiong E","year":"2010","journal-title":"Urology"},{"issue":"7","key":"ref5","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1381\/096089206777822269","article-title":"Prevention of trocar-wound hernia in laparoscopic bariatric operations","volume":"16","author":"Chiu CC","year":"2006","journal-title":"Obes Surg"},{"issue":"6","key":"ref6","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0002-9610(02)01098-X","article-title":"Establishing a laparoscopic gastric bypass program","volume":"184","author":"Dresel A","year":"2002","journal-title":"Am J Surg"},{"issue":"2","key":"ref7","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1001\/archsurg.135.2.208","article-title":"Prevalence and mechanisms of small intestinal obstruction following laparoscopic abdominal surgery: a retrospective multicenter study. French Association for Surgical Research","volume":"135","author":"Duron JJ","year":"2000","journal-title":"Arch Surg"},{"issue":"3","key":"ref8","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1308\/rcsann.2018.0216","article-title":"Gastric remnant perforation due to trocar site herniation after laparoscopic Roux-en-Y gastric bypass","volume":"101","author":"Ebrahimi R","year":"2019","journal-title":"Ann R Coll Surg Engl"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s00261-001-0156-y","article-title":"Value of CT after laparoscopic repair of postsurgical ventral hernia","volume":"28","author":"Gossios K","year":"2003","journal-title":"Abdom Imaging"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"5250","DOI":"10.1007\/s00464-020-07826-8","article-title":"Does closure of fascia, type, and location of trocar influence occurrence of port site hernias? A literature review","volume":"34","author":"Gutierrez M","year":"2020","journal-title":"Surg Endosc"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S2213-8587(19)30026-9","article-title":"The obesity transition: stages of the global epidemic","volume":"7","author":"Jaacks LM","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1007\/s00464-005-0747-8","article-title":"VersaStep trocar hernia rate in unclosed fascial defects in bariatric patients","volume":"20","author":"Johnson WH","year":"2006","journal-title":"Surg Endosc"},{"issue":"5","key":"ref13","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1016\/S0002-9378(11)90787-X","article-title":"Incisional hernias after major laparoscopic gynecologic procedures","volume":"168","author":"Kadar N","year":"1993","journal-title":"Am J Obstet Gynecol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1100\/tsw.2006.372","article-title":"Incisional hernia in a 12-mm nonbladed trocar site following laparoscopic nephrectomy","volume":"6","author":"Kouba EJ","year":"2006","journal-title":"ScientificWorldJournal"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10029-017-1725-5","article-title":"Comparing different modalities for the diagnosis of incisional hernia: a systematic review","volume":"22","author":"Kroese LF","year":"2018","journal-title":"Hernia"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1001\/archsurg.142.10.942","article-title":"Endoscopic findings in the excluded stomach after Roux-en-Y gastric bypass surgery","volume":"142","author":"Kuga R","year":"2007","journal-title":"Arch Surg"},{"issue":"5","key":"ref17","article-title":"Trocar site hernias from using bladeless trocars: should fascial closure be performed?","volume":"2014","author":"Lee J","year":"2014","journal-title":"J Surg Case Rep"},{"issue":"9","key":"ref18","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1177\/000313480006600911","article-title":"Laparoscopic port sites do not require fascial closure when nonbladed trocars are used","volume":"66","author":"Liu CD","year":"2000","journal-title":"Am Surg"},{"issue":"4, Part 2","key":"ref19","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1016\/S1074-3804(05)80946-6","article-title":"Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists","volume":"1","author":"Montz FJ","year":"1994","journal-title":"J Am Assoc Gynecol Laparosc"},{"issue":"4","key":"ref20","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/00001703-200208000-00002","article-title":"Laparoscopic access: complications, technologies, and techniques","volume":"14","author":"Munro MG","year":"2002","journal-title":"Curr Opin Obstet Gynecol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"183","DOI":"10.11604\/pamj.2018.29.183.14467","article-title":"Trocar site post incisional hernia: about 19 cases","volume":"29","author":"Nacef K","year":"2018","journal-title":"Pan Afr Med J"},{"issue":"2","key":"ref22","doi-asserted-by":"crossref","DOI":"10.1590\/0102-672020200002e1517","article-title":"Incisional hernioplasty techniques: analysis after open bariatric surgery","volume":"33","author":"Nassif AT","year":"2020","journal-title":"Arq Bras Cir Dig"},{"issue":"3","key":"ref23","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s00464-016-5113-5","article-title":"What is the BMI threshold for open ventral hernia repair?","volume":"31","author":"Pernar LIM","year":"2017","journal-title":"Surg Endosc."},{"issue":"4","key":"ref24","first-page":"523","article-title":"An epidemiological approach to obesity","volume":"17","author":"Pinheiro ARO","year":"2004","journal-title":"Rev Nutr"},{"issue":"4","key":"ref25","article-title":"Repercussions of bariatric surgery on metabolic parameters: experience of 15-year follow-up in a hospital in Macei\u00f3, Brazil","volume":"34","author":"Pinheiro JA","year":"2022","journal-title":"Arq Bras Cir Dig"},{"issue":"6","key":"ref26","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1089\/lps.1993.3.567","article-title":"Laparoscopic trocar site hernias","volume":"3","author":"Plaus WJ","year":"1993","journal-title":"J Laparoendosc Surg"},{"issue":"7","key":"ref27","first-page":"410","article-title":"Trocar site hernia: a more common problem than we believe?","volume":"97","author":"Rodr\u00edguez de Guzm\u00e1n CA","year":"2019","journal-title":"Cir Esp (Engl Ed)"},{"issue":"4","key":"ref28","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/00000658-200010000-00007","article-title":"Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity","volume":"232","author":"Schauer PR","year":"2000","journal-title":"Ann Surg"},{"issue":"1","key":"ref29","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/13645700152598888","article-title":"Access-related complications \u2013 an analysis of 6023 consecutive laparoscopic hernia repairs","volume":"10","author":"Schmedt CG","year":"2001","journal-title":"Minim Invasive Ther Allied Technol"},{"issue":"1","key":"ref30","first-page":"89","article-title":"Incision characteristics associated with six laparoscopic trocar-cannula systems: a randomized, observer-blinded comparison","volume":"94","author":"Tarnay CM","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"2","key":"ref31","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s11695-018-03652-z","article-title":"Alternative method of mesenteric defect closure after Roux-en-Y gastric bypass","volume":"29","author":"Wang E","year":"2019","journal-title":"Obes Surg"},{"issue":"11","key":"ref32","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1161\/CIRCRESAHA.116.307591","article-title":"Treatment of obesity: weight loss and bariatric surgery","volume":"118","author":"Wolfe BM","year":"2016","journal-title":"Circ Res"}],"container-title":["ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S\u00e3o Paulo)"],"original-title":["H\u00c9RNIA INCISIONAL AP\u00d3S A CIRURGIA BARI\u00c1TRICA: APENAS O EXAME F\u00cdSICO \u00c9 SUFICIENTE?"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-67202022000100326&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T11:38:39Z","timestamp":1676720319000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-67202022000100326&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":32,"alternative-id":["S0102-67202022000100326"],"URL":"https:\/\/doi.org\/10.1590\/0102-672020220002e1673","relation":{},"ISSN":["2317-6326","0102-6720"],"issn-type":[{"value":"2317-6326","type":"electronic"},{"value":"0102-6720","type":"print"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"e1673"}}