Hernia and abdominal wall: port-site hernia prevention: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia and abdominal wall: port-site hernia prevention

Sample item

Three weeks after laparoscopic cholecystectomy, a patient has colicky pain and vomiting with a tender small swelling at the umbilical port site. Which measure would best have prevented this?

AClosing the skin with a subcuticular suture aloneBUsing larger skin incisions for all portsCFascial closure at ports of 10 mm or largerDFascial closure at the 5 mm ports only

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Fascial closure at ports of 10 mm or larger

Port-site hernia, which may be of Richter type, arises through unclosed fascial defects, most often at the umbilical port. Fascial closure at ports of 10 mm and above is the standard preventive measure.

Option by option

A. Closing the skin with a subcuticular suture alone
Skin closure does not repair the fascial defect where the hernia forms.
B. Using larger skin incisions for all ports
Larger skin incisions do nothing for the fascia and can widen the defect.
C. Fascial closure at ports of 10 mm or larger (correct)
Correct. Fascial closure at larger ports prevents the defect through which bowel herniates.
D. Fascial closure at the 5 mm ports only
5 mm ports rarely herniate, so closure there leaves the large umbilical defect unprotected.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Fascial closure at ports of 10 mm or larger. Port-site hernia, which may be of Richter type, arises through unclosed fascial defects, most often at the umbilical port.

Why is "Closing the skin with a subcuticular suture alone" not the answer?

Skin closure does not repair the fascial defect where the hernia forms.

Why is "Using larger skin incisions for all ports" not the answer?

Larger skin incisions do nothing for the fascia and can widen the defect.

Why is "Fascial closure at the 5 mm ports only" not the answer?

5 mm ports rarely herniate, so closure there leaves the large umbilical defect unprotected.

What concept does this question test?

It tests Hernia and abdominal wall: port-site hernia prevention in General Surgery. Fascial closure at ports of 10 mm and above is the standard preventive measure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: port-site hernia prevention?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.