Various methods have been described to achieve adequate port closure. An effective method is to use a Langenbeck's retractor as shown in the Figure 1. The small limb of the retractor is slipped under the defect and the long limb is used to hold the abdominal wall up while the surgeon takes an adequate bite by sliding the needle on to the retractor blade underneath the fascia. This ensures a good bite while avoiding injury to bowel. The bite on the opposite edge is taken with ease by rotating the retractor. This method is especially useful in obese patients.
Figure 1.
Use of a Langenbeck's retractor to achieve adequate port closure.