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Updated: Jul 7, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Frequency of postoperative inguinal hernia after endoscope-assisted mini-laparotomy and conventional retropubic
Takuya Koie1, Takahiro Yoneyama, Noritaka Kamimura
1Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.
Objective:
The objective of the present study was to compare the incidence of postoperative inguinal hernia between endoscope-assisted mini-laparotomy retropubic radical prostatectomy (mini-lap RRP) with conventional techniques to identify possible risk factors.
Methods:
From April 1998 to December 2006, 347 consecutive cases with localized prostate cancer were treated with conventional RRP (75 cases) and mini-lap RRP (272 cases) with pelvic lymphadenectomy. Mini-lap RRP was carried out with a 6-cm median incision. The charts were retrospectively reviewed, and the incidence of and risk factors for postoperative inguinal hernia were assessed.
Results:
There were no significant differences in age, initial prostate-specific antigen concentrations, clinical stage, Gleason score, body mass index, incidence of previous major abdominal surgery (cholecystectomy, gastrectomy, and colectomy), previous appendectomy, and previous inguinal hernia repair between the two groups. Postoperative inguinal hernia was observed in 29 cases (38.7%) in the conventional RRP group and in eight cases (2.9%) in the mini-RRP group during the mean follow-up period of 26.1 months (range: 3-105 months). The patients treated with mini-lap RRP had significantly higher hernia-free survival than those treated with conventional RRP (log rank test, P < 0.001). Multivariate analysis showed that surgical technique (conventional RRP) and previous major abdominal surgery were risk factors for inguinal hernia (P < 0.001 and P = 0.007, respectively).
Conclusions:
Inguinal hernia was less frequent after mini-lap RRP than after conventional RRP. A history of a major abdominal surgery was an independent risk factor for this event.
Insights
Endoscope-assisted mini-laparotomy retropubic radical prostatectomy (mini-lap RRP) significantly reduces inguinal hernia risk compared to conventional RRP. Previous major abdominal surgery is an independent risk factor for hernias.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Postoperative inguinal hernia is a potential complication following radical prostatectomy.
- Conventional retropubic radical prostatectomy (RRP) has been associated with a notable incidence of inguinal hernias.
Purpose of the Study:
- To compare the incidence of postoperative inguinal hernias between endoscope-assisted mini-laparotomy RRP (mini-lap RRP) and conventional RRP.
- To identify risk factors associated with inguinal hernia development after these surgical techniques.
Main Methods:
- Retrospective review of 347 localized prostate cancer cases treated between April 1998 and December 2006.
- Comparison of conventional RRP (75 cases) and mini-lap RRP (272 cases) with pelvic lymphadenectomy.
- Assessment of hernia incidence and risk factors, including surgical history and patient demographics.
Main Results:
- Postoperative inguinal hernia occurred in 38.7% of conventional RRP cases versus 2.9% of mini-lap RRP cases.
- Mini-lap RRP demonstrated significantly higher hernia-free survival (P < 0.001).
- Multivariate analysis identified conventional RRP technique and prior major abdominal surgery as independent risk factors for inguinal hernia (P < 0.001 and P = 0.007, respectively).
Conclusions:
- Mini-lap RRP is associated with a lower incidence of inguinal hernias compared to conventional RRP.
- A history of major abdominal surgery independently increases the risk of developing an inguinal hernia post-prostatectomy.
