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Port site hernias following robot-assisted laparoscopic prostatectomy
Matthew Richard Hotston1,2, J D Beatty3, K Shendi3
1The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK. matthotston@hotmail.com.
Journal of Robotic Surgery
|September 16, 2016
Summary
Robot-assisted laparoscopic prostatectomy (RALP) can lead to rare port site hernias. Implementing non-bladed trocars and formal fascial closure for 12 mm ports can prevent these complications.
Area of Science:
- Urology
- Surgical Complications
- Minimally Invasive Surgery
Background:
- Port site herniation is a known complication of laparoscopic surgery.
- Its incidence and significance following robot-assisted laparoscopic prostatectomy (RALP) are not well-established.
Purpose of the Study:
- To report cases of port site hernia after RALP.
- To recommend modifications in surgical technique to prevent this complication.
Main Methods:
- Case series of two patients who developed port site hernias post-RALP.
- Review of current literature on trocar use and port site closure in RALP.
- Modification of surgical technique based on case review.
Main Results:
- Two patients presented with early vague abdominal symptoms and diagnosed small bowel herniation through a 12 mm port site.
- Both patients required surgical exploration and repair.
- The authors adapted their technique to use non-bladed trocars and formal fascial closure for 12 mm ports.
Conclusions:
- Port site hernias are a potential complication of RALP.
- Routine use of non-bladed trocars and formal fascial closure for 12 mm ports are recommended.
- Early recognition of abdominal signs and prompt CT imaging are crucial for diagnosis and management.
