Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy (original) (raw)
Related papers
Robot-assisted radical prostatectomy may induce inguinal hernia within the first 2 years
Medicine, 2018
At present, robot-assisted radical prostatectomy (RARP) is a gold standard in radical prostatectomy. The aim of this study was to evaluate the incidence, risk factors, and timing of occurrence of inguinal hernia (IH) after RARP. We included 427 patients with prostate cancer who underwent RARP by a single surgeon from February 2006 to August 2017. Incidence, clinical, and pathological factors were investigated to assess relationship with the development of IH. Postoperative IH occurred in 29 cases (6.79% of all RARP patients), whereas 22 cases (75.9% of all IH patients) occurred within the first 2 years. The median follow-up period was 5.2 years, and the median age of patients was 65 years. Postoperative IH occurrence was significantly associated with body mass index (BMI), smoking history, and low surgeon experience (P = .036, .023, and .048, respectively). However, low surgeon experience did not reach statistical significance after multivariate analysis. The overall incidence of IH after RARP was significantly associated with BMI and smoking history. With obvious incidence of IH within the first 2 years after operation which was not observed at the open prostatectomy, RARP itself may play a role in the development of IH. Abbreviations: AJCC = American Joint Committee on Cancer, BMI = body mass index, IH = inguinal hernia, IQR = interquartile range, LRP = laparoscopic radical prostatectomy, ORP = open retrospective radical prostatectomy, PPV = patent processus vaginalis, PSA = preoperative prostate-specific antigen, RARP = robot-assisted radical prostatectomy.
Journal of Urology
Inguinal hernia is a known sequel of radical prostatectomy which contributes to patient morbidity and health care expenditure. In this systematic review we evaluated the incidence of inguinal hernia associated with minimally invasive radical prostatectomy, in addition to predictive factors and preventive measures. Materials and Methods: We searched PubMedÒ and EmbaseÒ between 2000 and February 2018 using the search terms inguinal hernia and radical prostatectomy. Results: In concordance with search terms and selection criteria we identified a total of 155 reports with 27 studies eligible for inclusion. Collated results demonstrated a variable prevalence of inguinal hernia after laparoscopic radical prostatectomy and robotic assisted radical prostatectomy ranging from 4.3% to 8.3% and from 3% to 19.4 %, respectively. There was a higher mean prevalence of inguinal hernia after robotic assisted prostatectomy. Factors predicting inguinal hernia following minimally invasive radical prostatectomy included low body mass index, poor stream and straining prior to prostatectomy detected on symptom score instruments, a patent processus vaginalis or an intraoperative incidental inguinal hernia. Herniotomy or herniorrhaphy with onlay mesh repair was the most commonly reported intraoperative repair technique at the time of minimally invasive radical prostatectomy. Recurrence of repaired incidental hernia is rare. Conclusions: Inguinal hernia is common after minimally invasive radical prostatectomy. There is a lack of high level evidence to clarify risk factors and preventive strategies for inguinal hernia after minimally invasive radical prostatectomy. There is a justification for randomized controlled trials to further evaluate this under recognized clinical problem.
Robotic radical prostatectomy with concomitant repair of inguinal hernia: is it safe?
Journal of robotic surgery, 2017
Robotic radical prostatectomy (RARP) is well established as a safe and effective treatment for prostate cancer. According to published studies, patients undergoing RARP are at increased risk of being diagnosed with an inguinal hernia after RARP and are four times more likely to have an inguinal hernia repair (IHR) following RARP. Several studies have demonstrated the effectiveness and safety of IHR during RARP. Overall, it has been observed that IHR adds on average, 12-15 min in total surgical time and there were no significant differences between RARP with or without IHR with respect to postoperative complications. This study analyzes a large series of patients undergoing RARP (1100) and compares them to a group that underwent RARP with IHR (39). Between December 2008 and January 2015, 1139 patients underwent RARP at Florida Hospital in Celebration, FL. Of the total patients, 39 underwent concomitant IHR. All procedures were performed by the same surgeons (urologist and general sur...
Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy
Advances in Urology, 2015
Introduction. To explore the long term incidence and predictors of incisional hernia in patients that had RARP. Methods. All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair. Results. Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams; = 0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480); = 0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias. Conclusion. Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.
Hernia, 2020
In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy. Method Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires. Results 3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting. Conclusions We found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI.
2022
BackgroundThere are no reports of robot-assisted laparoscopic transabdominal preperitoneal inguinal hernia repair (R-TAPP) for the patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). AimTo evaluate the feasibility and safety of R-TAPP in patients who underwent RALP for postprostatectomy inguinal hernia (PIH).MethodsThis is a prospective, single-center retrospective cohort study. R-TAPP was conducted in 74 consecutive patients from September 2016 to March 2020. Except for women and patients who underwent previous abdominal surgery, 70 patients were classified into two groups based on the absence or presence of PIH (PIH group or non-PIH group). The data were retrospectively compared to those who had not undergone RALP.ResultsSeventy patients were reviewed. Among them, 22.9% had previously undergone RALP. We identified 22 lesions in 16 patients (unilateral in 10; bilateral in 6) in the PIH group, and 67 lesions in 54 patients (unilateral in 41; bilateral in...
No prostate? No problem. Robotic inguinal hernia repair after prostatectomy
Traditional teaching suggests that prior pelvic operations, including prostatectomy, is a contraindication to laparoscopic inguinal hernia repair. Despite the growing use of robotic platforms in inguinal hernia repair, there are few studies describing robotic-assisted inguinal hernia repairs (RIHR) in this patient population. This study aims to demonstrate that RIHR is safe and effective in repairing inguinal hernias in patients who had previously undergone prostatectomy. We retrospectively reviewed RIHR cases performed from March 2017 to October 2021 by a single surgeon at our university-affiliated community hospital. Cases were reviewed for preoperative considerations, operative times and complications, and postoperative outcomes. A total of 30 patients with prior prostatectomy underwent transabdominal preperitoneal (TAPP) RIHR with mesh. Sixteen of the 30 patients had undergone robot-assisted laparoscopic prostatectomy (RALP) while 14 patients underwent open resection. Seven of t...
In Vivo
Background: To evaluate the utility of robotassisted laparoscopic transabdominal preperitoneal repair (R-TAPP) of postprostatectomy inguinal hernia (PIH) in patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). Patients and Methods: This was a prospective, single-centre retrospective cohort study. R-TAPP was conducted in 74 consecutive patients from September 2016 to March 2020. With the exception of women and patients who underwent previous abdominal surgery, 70 patients were classified into two groups based on the absence or presence of PIH. Their data were retrospectively compared to those who had not undergone RALP. Results: The median operative time for the PIH group was longer compared to the non-PIH group. However, postoperative complications, including seroma formation, haematoma and surgical site infections, were not significantly different between the groups. The estimated blood loss was small, and hospitalisation duration was 1 day in all cases. Moreover, there were no hernia recurrences within the 90-day followup period in either group. Conclusion: R-TAPP is a feasible and safe approach for inguinal hernia repair, even in patients who undergo RALP for prostate cancer.