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Introduction <p>Laparoscopic techniques revolutionized modern surgical care. These minimally invasive procedures–offering better therapeutic and cosmetic outcome–rapidly gained widespread approval. Nevertheless, adaptation into routine practice presented unique challenges, including delayed port-site infections by non-tuberculous Mycobacteria. Despite a growing hazard, especially across the subcontinent, data remained underrepresented. The present work reported an outbreak at a tertiary care hospital of India, emphasizing on potential contributing factors.</p> Methods <p>A single-centre, record-based case series analysis of eight individuals presenting between July-August, 2019, with delayed infection of laparoscopic port-sites, clinically suggestive of non-tuberculous Mycobacteria. Medical data obtained from institutional archives were completely anonymized before analysis. No direct participant contact was made.</p> Results <p>Laparoscopic surgeries preceding the infection included a sleeve gastrectomy, Whipple procedure and 2 right hemicolectomies in women, and hernia repair via totally extraperitoneal approach in all 4 men. Fever with port-site discharge was the commonest presentation of delayed infection. Diagnosis involved identification of acid-fast bacilli by Ziehl-Neelsen staining, negative GeneXpert with positive real time polymerase chain reaction for non-tuberculous Mycobacteria and colonization of rapid growers in Lowenstein-Jensen medium. Record of sub-speciation, found for one individual, showed <i>Mycobacterium abscessus</i> infection. Treatment involved a combination therapy of second-line antimycobacterial drugs and mesh explantation.</p> Conclusion <p>Delayed port-site infection remained a serious concern following laparoscopic surgery in India. Environmental abundance of non-tuberculous Mycobacteria, contamination of surgical apparatus from water-sources and ineffective sterilization by the commonly employed disinfection protocols could be attributable. Further large-scale studies and adaptation of stringent sterilization as per international recommendations were warranted.</p>

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Silent Invaders of Laparoscopic Port-site: A Case Series Analysis on Non-tuberculous Mycobacteria from India

  • 期刊论文

  • 发表日期：

    2026年3月27日

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  • Sumesh Kaistha,
  • Samidh Shuddha Datta

摘要

Introduction

Laparoscopic techniques revolutionized modern surgical care. These minimally invasive procedures–offering better therapeutic and cosmetic outcome–rapidly gained widespread approval. Nevertheless, adaptation into routine practice presented unique challenges, including delayed port-site infections by non-tuberculous Mycobacteria. Despite a growing hazard, especially across the subcontinent, data remained underrepresented. The present work reported an outbreak at a tertiary care hospital of India, emphasizing on potential contributing factors.

Methods

A single-centre, record-based case series analysis of eight individuals presenting between July-August, 2019, with delayed infection of laparoscopic port-sites, clinically suggestive of non-tuberculous Mycobacteria. Medical data obtained from institutional archives were completely anonymized before analysis. No direct participant contact was made.

Results

Laparoscopic surgeries preceding the infection included a sleeve gastrectomy, Whipple procedure and 2 right hemicolectomies in women, and hernia repair via totally extraperitoneal approach in all 4 men. Fever with port-site discharge was the commonest presentation of delayed infection. Diagnosis involved identification of acid-fast bacilli by Ziehl-Neelsen staining, negative GeneXpert with positive real time polymerase chain reaction for non-tuberculous Mycobacteria and colonization of rapid growers in Lowenstein-Jensen medium. Record of sub-speciation, found for one individual, showed Mycobacterium abscessus infection. Treatment involved a combination therapy of second-line antimycobacterial drugs and mesh explantation.

Conclusion

Delayed port-site infection remained a serious concern following laparoscopic surgery in India. Environmental abundance of non-tuberculous Mycobacteria, contamination of surgical apparatus from water-sources and ineffective sterilization by the commonly employed disinfection protocols could be attributable. Further large-scale studies and adaptation of stringent sterilization as per international recommendations were warranted.