Port-site complications after pediatric urologic robotic surgery

Area of Science:

• Pediatric Surgery
• Urology
• Minimally Invasive Surgery

Background:

• Port-site hernias are a known complication of adult laparoscopic surgery, occurring in 0.1% to 3.0% of cases.
• Limited data exists on hernia incidence and related factors following pediatric urologic laparoscopic interventions.

Purpose of the Study:

• To evaluate port-site complications, including hernia incidence, following pediatric urologic robotic surgery (PURS).
• To analyze potential contributing factors such as port size, location, and fascial closure.

Main Methods:

• Prospective follow-up of the first 200 PURS cases (July 2005-June 2009) at Children's Hospital of Philadelphia.
• Analysis of 600 port sites, assessing outcomes based on size, location, and fascial closure.
• Minimum 2-month postoperative follow-up for all patients.

Main Results:

• One umbilical port site hernia (0.17%) was diagnosed 2 weeks postoperatively.
• Four port sites (0.67%) developed skin dehiscence due to superficial wound infection within 1 week.
• Overall port-site complication incidence was 0.83% (1 hernia + 4 dehiscences).

Conclusions:

• The incidence of port-site complications after PURS is low (0.83%), comparable to or lower than reported rates in adult laparoscopic surgery.
• The low incidence of complications makes it challenging to identify specific risk factors.
• Further research with larger cohorts may be needed to elucidate contributing factors to port-site complications in PURS.