The Port Site Suture System Trocar (PSSST) can also be used for repairing an established port site hernia. This involves the production of an instrument that can pass down a 5mm port which is effectively a narrow rod with a cup shaped end to guide the trocar into the abdominal cavity through the hernia site from within the peritoneal cavity. It is represented in the diagram below. Alternatively the end of a sucker could be used as the guide.

Having inserted the laparoscope well away from the port site hernia to be closed, a 5mm port is inserted into the abdomen as far away from the port site hernia as reasonably possible. The above instrument is inserted into the 5mm port and pushed into the hernia. The cup shaped end can then be felt through the abdominal wall.

 

An incision is made in the skin, fat and peritoneum to reveal the cup shaped end. The tip of the trocar is inserted into the cup shaped end.

It can now be pushed into the abdomen led by the guiding instrument, pushing the hernial sack back into the abdomen. The trocar is then in place to suture the hernia site as described previously.