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Updated: Nov 23, 2025
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Port site hernia at the robotic arm port after robotic-assisted laparoscopic radical prostatectomy
Taiki Ogasa1, Masayoshi Nagata1, Hiroki Koyasu1
1Department of Urology Juntendo University Graduate School of Medicine Tokyo Japan.
Introduction:
Complications unique to laparoscopic surgery have been reported, including port site hernia. We experienced a case of port site hernia in the robotic right-hand port site measuring 8 mm in diameter after robotic-assisted laparoscopic radical prostatectomy.
Case Presentation:
A 56-year-old man was indicated a high prostate-specific antigen level of 37.8 ng/ml. Subsequent prostate biopsy revealed adenocarcinoma with a Gleason score of 4 + 4. The patient underwent robotic-assisted laparoscopic radical prostatectomy in Juntendo Hospital. Although his postoperative recovery was generally good, the patient complained of sudden nausea and acute abdominal pain. A contrast computed tomography scan showed an ileus due to a hernia occurring at the robotic right-hand port, the da Vinci Arm I port. We released incarceration under laparoscopic procedure.
Conclusion:
Since the port diameter is relatively small in robot-assisted surgery, port site hernias are expected to be rare. However, careful attention should be paid to the positional deviation of the remote center.
Insights
A rare port site hernia occurred after robotic prostatectomy through an 8mm port. This complication, though uncommon in robotic surgery, highlights the need for vigilance regarding trocar site management and remote center positioning.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Complications
Background:
- Laparoscopic surgery can lead to unique complications, such as port site hernias.
- Robotic-assisted surgery, while often associated with smaller ports, is not immune to these risks.
- Radical prostatectomy is a common procedure where these complications may arise.
Observation:
- A 56-year-old male presented with elevated prostate-specific antigen and adenocarcinoma.
- He underwent robotic-assisted laparoscopic radical prostatectomy.
- Postoperatively, the patient developed nausea and abdominal pain, diagnosed as an ileus secondary to a hernia at the 8mm robotic port site.
Findings:
- The hernia occurred at the da Vinci Arm I port site.
- The hernia was successfully treated with a laparoscopic procedure to release the incarceration.
- This case demonstrates a rare but significant complication in robotic surgery.
Implications:
- Despite smaller port sizes in robotic surgery, port site hernias remain a possibility.
- Careful attention to trocar site closure and management is crucial.
- Understanding and mitigating risks associated with the remote center of the robotic system is essential for patient safety.
