■ the length of the suture material should be 4:1 to the length of the wound
■ avoid excessive tension on the suture closure of the fascial edgestraction as it may compromise vascularization of the wound edges
■ below the umbilicus, the posterior fascia (rostral to the smi-circular line caudal to which there is no posterior rectus fascia) and then the anterior fascia of the rectus abdominis muscle can bei closed as separate layers
■ Grasp the needle with the tip of the instrument
■ The fascia is closed with a running loop of monofilament, absorbable suture material (e.g., PDS II-1 loop or Maxon-1 loop) with or without inclusion of the peritoneum
■ The subcutaneous fatty layer is not closed and subcutaneous drains are rarely needed
■ The skin is preferably closed with a running intracutaneous absorbable monofilament suture (e.g.,Maxon 5-0) or with staples
■ In contrast to the midline laparotomy, the fascia should be closed in two layers Trocar Wound Closure
■ Ports are removed under direct vision with the camera and port sites should be routinely watched for 10 s to exclude port site bleeding
■ All fascial defects of trocars greater than 5 mm are closed with absorbable sutures (e.g.,Vicryl 0)
■ The skin is closed with interrupted mattress sutures (e.g., Dermalon 4-0) or with staples
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