Port Site Implants

Port site implants were described in the early reports, so it was suggested that laparoscopic colorectal resection only be performed within controlled trials [1]. The reported port site metastases [2] occurred soon after the colorectal resection in patients with large tumours, and when the cancer was heavily manipulated during the procedure, thus suggesting the possibility of neoplastic cell exfoliation during the resection [3]. With growing experience, it is now clear that the incidence of port site metastases is no different from that of wound recurrence after conventional open surgery, as reported by several Authors [4-12]. Nevertheless, adequate manoeuvres are needed to prevent this complication, avoiding tumour manipulation, preventing air leakage through port sites (the so-called chimney effect) and desufflating the abdomen before removing the trocars. The use of proper sleeve wound protection for the mini-laparotomy is also recommended, to avoid contact between the colon and the wound during the exteriorisation of the specimen because cancer implants have been described at the extraction site.

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