Evaluation of the Risk Factors for the Incisional Hernia Occurrence After Robot-Assisted Laparoscopic Radical...

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robot-assisted laparoscopic radical prostatectomy (RALRP) is a common procedure for prostate cancer.
• Incisional hernia (IH) is a potential complication following abdominal surgery.
• The method of surgical specimen removal may influence IH occurrence.

Purpose of the Study:

• To evaluate patient-related factors and compare specimen removal techniques (trocar extension [TE] vs. Pfannenstiel incision [PF]) for incisional hernia (IH) occurrence after RALRP.
• To assess oncological and functional outcomes in relation to IH.

Main Methods:

• Retrospective analysis of 192 patients undergoing RALRP between November 2017 and March 2021.
• Comparison of IH rates between the TE (n=135) and PF (n=57) specimen removal groups.
• Analysis of preoperative patient/tumor characteristics, postoperative complications, and functional/oncological outcomes.

Main Results:

• No statistically significant demographic or surgical technique-related factors were identified for IH occurrence.
• IH was detected in 16 patients (14 TE group, 2 PF group), with a trend towards higher incidence with TE (P = .156).
• No significant differences in oncological or functional outcomes were observed between the TE and PF groups.

Conclusions:

• Neither patient demographics nor surgical technique significantly predicted incisional hernia (IH) after RALRP in this cohort.
• While the trocar extension (TE) technique showed a higher IH rate than the Pfannenstiel incision (PF), the difference was not statistically significant.
• Both TE and PF techniques demonstrated comparable early oncological and functional outcomes in RALRP.