INTRODUCTION Minimal access surgery is a routine surgical practice due to its minimal invasive and associated advantages. It has a lot of advantages but not devoid of complication, one of the major concerned complication is the trocar site herniation (TSH). TSH is a serious complication often requiring emergency repair. If unattended, TSH can lead to small bowel strangulation and incarceration. The literature says that preventative measures should be taken to avoid the occurrence of herniation at the portal site. Fascial closure has been recommended as a means of TSH prevention. One study reported a statistically higher frequency of hernia at 12 mm port site where the fascia was left open (8%) compared with those that were closed (0.22%) following laparoscopy. There is a consensus that all the port site ≥10 mm should be closed due to an increased risk of herniation. For smaller ports, fascial closure may not be necessary, except when manipulated extensively. Trocar site herniation is also associated with other technical factors other than the port site. Port location is another factor. There are many reports suggesting that umbilical sites are at greater risk of herniation when compared to lateral port sites. This is due to weakness of the fascia and absence of supporting muscle in the area. Stretching or even extending the incision of a port site during specimen extraction has a great risk hernia development. Factors such as high body mass index (BMI) are patient-related risk factors that are associated with TSH. Here it is related to increase intra- abdominal pressure and increase abdominal wall thickness. Studies show that wound infection is a predisposing factor to hernia development. Therefore, closure of fascia is necessary for umbilical ports, ports sites that are stretched or enlarged for specimen retrieval, and trocar sites in obese patients. Minimally invasive laparoscopic surgery has revolutionized the way surgery is performed for an increasing number of patients. Incisional hernia can occur after any abdominal surgery and laparoscopic surgery is not immune to this complication. The hernia that follows laparoscopy usually occurs through the larger ports (size >10 mm), especially the umbilicus. Fig. 1: Typical port closure needle. Laparoscopic Port Closure Technique Predisposing factors include: ■ Previous laparoscopies ■ Extensive manipulation during surgery ■ Increased intra-abdominal pressure ■ Obesity ■ Use of sharp cutting-tip trocars ■ Rapid abdominal deflation at the end of surgery ■ Poor port removal techniques and defective closure of the abdominal fascia ■ Wound extension ■ Male sex ■ Infection of the wound ■ Pre-existing umbilical defects ■ Postoperative chest infections ■ Pre-existing diseases such as diabetes mellitus ■ Connective tissue disorders ■ Job profile of the patient (weight lifting). Among all these factors, the single most important factor remains the improper closure of the fascial defects at the port sites and not using proper port closure instruments (Figs. 1 to 3) . The diagnosis is often delayed because most cases present late, and treatment might be instituted along other lines. Computed tomography scans are helpful in its diagnosis and will facilitate prompt treatment to avoid the grave consequence of bowel gangrene. Prof. Dr. R. K. Mishra