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Epigastric hernia contiguous with the laparoscopic port site after endoscopic robotic total prostatectomy

Yoshihiro Moriwaki1, Jun Otani1, Junzo Okuda1

  • 1Department of Surgery, Unnan City Hospital, Unnan, Japan.

Asian Journal of Endoscopic Surgery
|March 25, 2018
PubMed

Insights

Minimally invasive surgeries like laparoscopic and robotic procedures can lead to epigastric hernias due to linea alba defects. Surgeons should consider preventative sutures to avoid these incisional hernias.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Abdominal Wall Reconstruction

Background:

  • Laparoscopic and endoscopic robotic surgery are standard for abdominal procedures.
  • Port site closure can be challenging, potentially causing incisional hernias.
  • Progressive thinning of the linea alba can lead to epigastric hernias.

Observation:

  • A case of epigastric hernia adjacent to a port site scar after robotic prostatectomy was observed.
  • Imaging revealed significant linea alba width (30-48 mm) and prior thinning.
  • This highlights a potential complication of minimally invasive abdominal surgery.

Findings:

  • Port site defects, especially cranially, are implicated in incisional hernias.
  • Thinning of the linea alba pre-disposes patients to epigastric hernia formation.
  • Endoscopic robotic surgery carries a risk of developing epigastric hernias.

Implications:

  • Awareness of epigastric hernia risk is crucial after laparoscopic and robotic surgery.
  • Consider prophylactic sutures cranial to port sites in high-risk patients.
  • Improved port site closure techniques may prevent abdominal wall defects and hernias.
Keywords:
Endoscopic robotic surgeryepigastric hernia of linea albaport-site hernia

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