Effectiveness of Small Bites Closure in Reducing Incisional Hernia at Specimen Extraction Sites Following Minimally Invasive Colorectal Cancer Surgery

A total of 246 patients were included in the study, divided into small bites (n=112) and mass closure (n=134) groups, with a median age of 69 years (range 31-89). The overall incidence of IH was 13.4% (n=33). IH rates were significantly lower in the small bites group (5.3%; n=6) compared to the mass closure group (19.9%; n=27) (p=0.006). Midline extraction sites had a higher IH incidence (16.8%) compared to off-midline sites (1.8%) (p=0.003). Additionally, patients with a BMI ≥30 kg/m² had a higher IH incidence (24.2%) compared to those with a BMI <30 kg/m² (8.9%) (p=0.003). Conclusion<i>: </i>This study suggests that the small bites technique significantly reduces the incidence of IH at extraction sites in minimally invasive colorectal cancer resections compared to mass closure. Patient factors such as body mass index (BMI) and extraction site location are also critical in IH development.