Background <p>Port-site hernias are a recognized complication of minimally invasive surgery, particularly occurring when large trocars are employed. Although fascial closure is crucial for preventing port-site hernias, achieving closure can be technically challenging, especially in overweight or obese patients. Recently, a 12-mm port featuring an integrated fascial closure system has been introduced, but its clinical safety and efficacy have not been thoroughly assessed.</p> Methods <p>This was a multicenter, prospective observational cohort study. We enrolled patients undergoing laparoscopic or robot-assisted surgery in which the VersaOne™ Fascial Closure System (Medtronic, Minneapolis, MN, USA) was utilized for a 12-mm port. Specifically, patients with an abdominal wall thickness of ≥ 30&#xa0;mm were included. The primary outcome was the incidence of port-site hernias at 6&#xa0;months postoperatively, confirmed through CT imaging and clinical examination. Secondary outcomes included closure time, intraoperative bleeding, infection, collateral organ damage, hospital readmission, and reoperation. Complications were graded according to the Clavien–Dindo classification.</p> Results <p>Among 103 patients (median body mass index, 27.1&#xa0;kg/m²), the median abdominal wall thickness was 36.1&#xa0;mm. The median closure time of 56.0&#xa0;s showed a weak correlation with wall thickness (r = 0.164). A single case of minor intraoperative bleeding was reported. No port-site hernias or other port-site complications were noted at 6&#xa0;months.</p> Conclusions <p>The VersaOne™ Fascial Closure System appears to be a safe and efficient method for fascial closure in minimally invasive surgery. Its use was particularly beneficial in patients with thick abdominal walls. Further randomized controlled studies are warranted to comprehensively validate these findings.</p> Graphical abstract <p></p>