Comparison of Port Site Infection Between Disposable Plastic and Metallic Ports in Total Laparoscopic Hysterectomy: ASingle CenterRetrospective Cohort Study: Port-Site Infection in TLH

zubia Afzal; Samina Saleem; Alia Bano; Talha Laique

doi:10.70384/jlmdc.v3i01.99

Authors

Zubia Afzal Department of Gynae Endoscopy & Obstetrics, Patel Hospital, Karachi
Samina Saleem Department of Gynae Endoscopy & Obstetrics, Patel Hospital, Karachi
Alia Bano Department of Gynae Endoscopy & Obstetrics, Patel Hospital, Karachi
Talha Laique Department of Medicine, Mayo Hospital, Lahore

DOI:

https://doi.org/10.70384/jlmdc.v3i01.99

Keywords:

Surgical wound Infection, Laparoscopy, Hysterectomy

Abstract

Background: Laparoscopic surgery has revolutionized gynecological procedures by offering a minimally invasive approach, faster recovery, and reduced postoperative pain.

Objective: To compare the incidence of Port Site Infection (PSI) in patients undergoing Total Laparoscopic Hysterectomy (TLH) using disposable plastic ports versus reusable metallic ports at a private tertiary care hospital.

Methodology: It was a retrospective cohort study held at the Department of Gynae Endoscopy & Obstetrics following ethical approval. Retrospective data was collected from 2010 to 2025. Women who underwent total laparoscopic hysterectomy at the institution within the defined study period were enrolled. All the data was processed by SPSS 28.0. Quantitative variables were presented as mean ± SD. Qualitative variables were presented as frequencies and percentages. Comparisons between groups were performed using Fisher's exact test, with a p-value ≤0.05 considered statistically significant.

Results: A total of 24 patients were included in the study. The mean age was 50.4 ± 4.1 years in Group A and 48.9 ± 6.5 years in Group B, with a mean BMI of 28.4 ± 12.5 kg/m². All patients in both groups had positive PSI. No significant differences were observed in demographic or clinical parameters between the groups. However, wound debridement was more frequent in the disposable port group, showing a statistically significant difference (p-value = 0.05).

Conclusion: Port-site infections occurred in both plastic and metallic port groups, with no statistically significant difference between them. These findings indicated that port material alone may not be a major independent determinant of infection risk.

References

1. Alkatout I, Mechler U, Mettler L, Pape J, Maass N, Biebl M, et al. The development of laparoscopy: a historical overview. Front Surg. 2021;8:799442.

Doi: https://doi.org/10.3389/fsurg.2021.799442

2. Manivasagam SS, Choudhary S, Manocha P, Reddy BH, Chandra JN, Manocha III P, et al. Insights into Laparoscopic Port Site Complications: A Comprehensive Review. Cureus. 2024;16(6):e63431.

Doi: https://doi.org/10.7759/cureus.63431

3. Ki HJ, Park JB, Sul JY. Umbilical port site hernia and diastasis recti. J Minim Invasive Surg. 2020;23:80-85.

Doi: https://doi.org/10.7602/jmis.2020.23.2.80

4. Molloy D, Kaloo PD, Cooper M, Nguyen TV. Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry. Aust N Z J Obstet Gynaecol. 2002;42(3):246-254.

Doi: https://doi.org/10.1111/j.0004-8666.2002.00246.x

5. Karthik S, Augustine AJ, Shibumon MM, Pai MV. Analysis of laparoscopic port site complications: A descriptive study. J Minim Access Surg. 2013;9(2):59-64.

Doi: https://doi.org/10.4103/0972-9941.110964

6. Perrotta G. Port-site metastasis (PSM): definition, clinical contexts and possible preventive actions to reduce risk. J Surg Surg Res. 2021;7(3):088-092.

Doi: https://doi.org/10.17352/2455-2968.000144

7. Wittich P, Mearadji A, Marquet RL, Bonjer HJ. Irrigation of port sites: prevention of port site metastases? J Laparoendosc Adv Surg Tech A. 2004;14(3):125-129.

Doi: https://doi.org/10.1089/1092642041255423

8. Gao Q, Guo L, Wang B. The pathogenesis and prevention of port-site metastasis in gynecologic oncology. Cancer Manag Res. 2020;12:9655-9663.

Doi: https://doi.org/10.2147/CMAR.S27088

9. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-332.

Doi: https://doi.org/10.1016/j.ajic.2008.03.002

10. Mihretie KM, Asmamaw MA, Anteneh ZA. Development and validation of a predictive nomogram for surgical site infection among general surgery patients in Amhara region Ethiopia. Sci Rep. 2025;15(1):10322.

Doi: https://doi.org/10.1038/s41598-025-85939-7

11. Rasa K, Kilpatrick C. Implementation of World Health Organization guidelines in the prevention of surgical site infection in low- and middle-income countries: what we know and do not know. Surg Infect. 2020;21(7):592-598.

Doi: https://doi.org/10.1089/sur.2020.163

12. Shiferaw WS, Aynalem YA, Akalu TY, Petrucka PM. Surgical site infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Surg. 2020;20(1):107.

Doi: https://doi.org/10.1186/s12893-020-00764-1

13. Tomomatsu Y, Takasawa E, Iizuka Y, Mieda T, Inoue H, Kimura A, et al. Impact of hypertension in diabetes on surgical outcomes after cervical laminoplasty - a retrospective, multi-institutional study of 1002 patients. Eur Spine J. 2025;34(4):1301-1308.

Doi: https://doi.org/10.1007/s00586-025-08673-8

14. Chiang TY, Wang YK, Huang WC, Huang SS, Chu YC. Intraoperative hypotension in non-emergency decompression surgery for cervical spondylosis: The role of chronic arterial hypertension. Front Med (Lausanne). 2022;9:943596.

Doi: https://doi.org/10.3389/fmed.2022.943596

15. Chandrupatla SR, Rumalla KC, Singh JA. Hypothyroidism impacts clinical and healthcare utilization outcomes after primary total hip arthroplasty. J Arthroplasty. 2024;39(9S2):S279-S286.e3.

Doi: https://doi.org/10.1016/j.arth.2023.11.005

16. Alavi SMA, Borgonovo F, Petri F, Matsuo T, Gori A, Shaw JD, et al. Defining postoperative spinal infections: navigating the inconsistencies in diagnostic definitions. J Bone Jt Infect. 2025;10(6):451-457.

Doi: https://doi.org/10.5194/jbji-10-451-2025

17. de Jonge SW, Boldingh QJJ, Solomkin JS, Allegranzi B, Egger M, Dellinger EP, et al. Systematic review and meta-analysis of randomized controlled trials evaluating prophylactic intra-operative wound irrigation for the prevention of surgical site infections. Surg Infect (Larchmt). 2017;18(4):508-519.

Doi: https://doi.org/10.1089/sur.2016.272

18. Charernsuk M, Tunruttanakul S, Jamjumrat L, Chareonsil B. Evaluation of preoperative antibiotic prophylaxis in clean-wound general surgery procedures: a propensity score-matched cohort study at a regional hospital. BMC Surg. 2024;24(1):294.

Doi: https://doi.org/10.1186/s12893-024-02616-8

19. Cao Q, Fan P, Feng J, Cheng T, Wang X, Cheng C, et al. Comprehensive analysis of the pathogen spectrum and antibiotic resistance profiles in periprosthetic joint infections: a single center retrospective study. Front Surg. 2025;12:1566689.

Doi: https://doi.org/10.3389/fsurg.2025.1566689

20. Ailioaie RC, Stefanescu E, Leahu C, Boldis A, Scurtu R. The influence of analgesic wound infiltration on postoperative pain and inflammatory cytokines in open colorectal surgery: a randomized comparative pilot study. Medicina (Kaunas). 2024;60(8):1244.

Doi: https://doi.org/10.3390/medicina60081244

21. Swanson T, Ousey K, Haesler E, Bjarnsholt T, Carville K, Idensohn P, et al. IWII wound infection in clinical practice consensus document: 2022. J Wound Care. 2022;31(Sup12):S10-S21.

Doi: https://doi.org/10.12968/jowc.2022.31.Sup12.S10

22. Sasmal PK, Mishra TS, Rath S, Meher S, Mohapatra D. Port site infection in laparoscopic surgery: A review of its management. World J Clin Cases. 2015;3(10):864-871.

Doi: https://doi.org/10.12998/wjcc.v3.i10.864