ArticleJournal of abdominal wall surgery : JAWS2026
Prevention with Sublay Mesh of Trocar Site Hernia (PRESUME): Study Protocol for a Multicenter Randomized Controlled Trial.
Article in Journal of abdominal wall surgery : JAWS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Trocar Site Incisional Hernia (TSIH) is the most common postoperative complication after laparoscopic surgery, with incidences exceeding 30% in high-risk patients. Despite advances in minimally invasive approaches, optimal preventive strategies remain uncertain, and evidence comparing closure or reinforcement techniques is limited. Prophylactic mesh use shows benefits in open surgery, but its role in laparoscopy requires further clarification. Objective: The PRESUME study evaluates whether prophylactic sublay mesh placement at the umbilical trocar site reduces TSIH incidence in patients undergoing laparoscopic cholecystectomy who present at least one established risk factor. Secondary objectives include assessing mesh-related complications and short- and long-term postoperative outcomes. Methods: This prospective, multicentre, randomised controlled trial provides Level I evidence. Eligible participants are adults scheduled for laparoscopic cholecystectomy with diabetes mellitus, BMI ≥30 kg/m Discussion: TSIH remains a significant postoperative issue with limited preventive evidence in laparoscopy. By assessing the efficacy and safety of prophylactic sublay mesh reinforcement, the PRESUME trial may support future recommendations and improve outcomes in high-risk patients.
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