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Updated: Jun 6, 2025
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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
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Incidence of Incisional Hernias after Single-Port Versus Multi-Port Robotic Radical Prostatectomy
J Corbin Norton1, Tyler Compher2, Luke Shumaker1
1Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Journal of Endourology
|November 29, 2024
Summary
Single-port robotic-assisted radical prostatectomy (SP-RARP) may increase the risk of incisional hernias compared to multi-port (MP-RARP). Higher BMI and prior surgeries are key risk factors for developing these hernias post-procedure.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Robotic-assisted radical prostatectomy is a standard treatment for prostate cancer.
- Single-port (SP-RARP) and multi-port (MP-RARP) approaches offer different surgical experiences.
- Incisional hernias are a potential complication following abdominal surgery.
Purpose of the Study:
- To compare the incidence of incisional hernias between SP-RARP and MP-RARP.
- To identify risk factors associated with incisional hernia development after robotic prostatectomy.
Main Methods:
- Retrospective review of 493 robotic prostatectomy cases (2017-2022).
- Analysis of incisional hernia rates based on CT imaging and clinical data.
- Multivariable logistic and Cox regression models used to assess risk factors and approach-specific outcomes.
Main Results:
- Overall incisional hernia rate was 8.5% (SP-RARP 8.1% vs. MP-RARP 9.2%, p=0.669).
- SP-RARP demonstrated shorter operative times (p < 0.001).
- Higher BMI (OR 1.07) and prior surgery history (OR 2.23) were linked to increased hernia risk. SP-RARP showed a 3.4x higher likelihood of incisional hernias (HR 3.38) after adjusting for follow-up.
Conclusions:
- Patients with higher BMI and previous abdominal surgeries face elevated risks of incisional hernias.
- Single-port robotic-assisted radical prostatectomy is associated with a higher risk of postoperative incisional hernias compared to the multi-port approach.
