AI‑ASSISTED SCORE FOR OPTIMAL PORT INSERTION AND CLOSURE IN LAPAROSCOPIC SURGERY ameralqadi2002@yahoo.com

366-05

AI‑ASSISTED SCORE FOR OPTIMAL PORT INSERTION AND CLOSURE IN LAPAROSCOPIC SURGERY

1

United Arab Emirates

Oral or Poster

Trocar‑site incisional hernia(TSIH)remains under-recognized,with prospective imaging studies reporting higher rates than historically appreciated.Risk is concentrated at larger(≥10–12 mm)ports and at midline/umbilical sites,&is amplified by obesity,advanced age,smoking,wound infection,&fascial enlargement for specimen extraction.Current practice often applies uniform closure rules rather than individualized risk mitigation.We propose an AI‑assisted scoring framework to support patient‑specific port planning&closure decisions.

We synthesized odds and hazard ratios from the literature to derive preliminary point weights for a multivariate risk score. Candidate predictors encompassed patient factors(age,BMI,sex,smoking status,chronic respiratory disease,occupation with unavoidable heavy lifting)&anatomic/procedural factors (abdominal circumference at the umbilicus with upper&lower abdominal measures,port site&size,planned fascial enlargement for extraction,and trocar trajectory—perpendicular versus oblique/Z‑entry).Points were assigned proportional to reported effect sizes and physiologic plausibility(e.g.,intra‑abdominal pressure).The primary outcome for future validation is TSIH within 12 months confirmed clinically and/or by imaging;secondary outcomes include acute port‑site complications,conversion,&re‑intervention.

The preliminary rubric stratifies risk as Low(0–3),Moderate(4–7),&High(≥8).High‑risk profiles trigger practical recommendations:avoid umbilical ≥10–12mm ports when feasible;prefer lateral 5 mm ports for non‑extraction tasks;employ angled/Z‑entry;close all ≥10 mm defects meticulously &consider closure devices for 8–10 mm in high‑risk contexts;minimize fascial enlargement and consider alternative extraction sites.This structured approach is expected to reduce TSIH&standardize decision‑making while preserving minimally invasive advantages

An AI-assisted, risk-stratified approach to port selection and closure can standardize decisions and potentially reduce trocar-site incisional hernia; multicentre prospective validation is required before broad adoption.