Are we failing to consent to an increasingly common complication? Incisional hernias at robotic prostatectomy
Tóm tắt
The use of robot-assisted laparoscopic radical prostatectomy (RALP) continues to increase in the management of prostate cancer by minimally invasive approach, with shorter convalescence, reduced blood transfusion and improving oncological outcomes when compared to open surgery. There is a growing evidence base that RALP is significantly associated with incisional hernia (IH) at the specimen extraction site compared to open surgery. A series of 186 RALP patients between August 2012 and August 2018 was reviewed, where 1–7 years follow-up had been observed. The study endpoint was IH rate at the supraumbilical specimen extraction site utilized by the surgeon. Incisional hernia rate at specimen extraction site was 8.6% and incidental 1.1% IH rate at a lateral port site (not associated with specimen removal). Average age at operation was 60.9 years old and hernias were diagnosed at a mean of 11.8 months post-surgery. Common demographics in the population suffering from IH were previous abdominal surgery, adhesiolysis, history of smoking and obesity. Supraumbilical extraction site hernias are an underreported complication of RALP which may impact on quality of life and prompt further surgical correction. Patients should be asked for consent regarding the possibility of this complication ensuing.
Tài liệu tham khảo
Seveso M, Melegari S, Bozzini G, De Francesco O, Mandressi A, Taverna G (2017) Does site of specimen extraction affect incisional hernia rate after robot assisted laparoscopic radical prostatectomy? Int J Surg 47:96–100
Huang H, Muscatelli S, Naslund M, Badiyan SN, Kaiser A, Siddiqui MM (2019) Evaluation of cancer specific mortality with surgery versus radiation as primary therapy for localized high grade prostate cancer in men younger than 60 years. J Urol 201(1):120–128
Basiri A, de la Rosette JJ, Tabatabaei S, Woo HH, Laguna MP, Shemshaki H (2018) Comparison of retropubic, laparoscopic and robotic radical prostatectomy: who is the winner? World J Urol 36(4):609–621
Schroeck FR, Krupski TL, Sun L, Albala DM, Price MM, Polascik TJ et al (2008) Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy. Eur Urol 54(4):785–793
Chennamsetty A, Hafron J, Edwards L, Pew S, Poushanchi B, Hollander J et al (2015) Predictors of incisional hernia after robotic assisted radical prostatectomy. Adv Urol 2015:7
Harr JN, Juo YY, Luka S, Agarwal S, Brody F, Obias V (2016) Incisional and port-site hernias following robotic colorectal surgery. Surg Endosc 30(8):3505–3510
Hermann M, Gustafsson O, Sandblom G (2017) Incidence of incisional hernia after minimally invasive and open radical prostatectomy: a population-based nationwide study. Scand J Urol 51(4):264–268
Fuller A, Fernandez A, Pautler SE (2011) Incisional hernia after robot-assisted radical prostatectomy–predisposing factors in a prospective cohort of 250 cases. J Endourol 25:1021+
Kang DI, Woo SH, Lee DH, Kim IY (2012) Incidence of port-site hernias after robot-assisted radical prostatectomy with the fascial closure of only the midline 12-mm port site. J Endourol 26(7):848–851
Martinez-Serrano MA, Pereira JA, Sancho JJ, Lopez-Cano M, Bombuy E, Hidalgo J (2010) Risk of death after emergency repair of abdominal wall hernias. Still waiting for improvement. Langenbecks Arch Surg 395(5):551–556
Ozkan E, Yildiz MK, Cakir T, Dulundu E, Eris C, Fersahoglu MM et al (2012) Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience). Ulus Travma Acil Cerrahi Derg 18(5):389–396
AIHW (2019) Prostate cancer in Australia statistics: Cancer Australia https://prostate-cancer.canceraustralia.gov.au/statistics. Accessed 5 Feb 2020
Carter S, Le JD, Hu JC (2013) Anatomic and technical considerations for optimizing recovery of sexual function during robotic-assisted radical prostatectomy. Curr Opin Urol 23(1):88–94
Beck S, Skarecky D, Osann K, Juarez R, Ahlering TE (2011) Transverse versus vertical camera port incision in robotic radical prostatectomy: effect on incisional hernias and cosmesis. Urology 78(3):586–590
Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72(1):70–71
Pereira JA, Bravo-Salva A, Montcusí B, Pérez-Farre S, Fresno de Prado L, López-Cano M (2019) Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters. BMC Surg 19(1):103
Israelsson LA, Smedberg S, Montgomery A, Nordin P, Spangen L (2006) Incisional hernia repair in Sweden 2002. Hernia 10(3):258–261
Maia R, Salgaonkar H, Lomanto D, Shabbir A (2019) Ventral hernia and obesity: is there a consensus? Ann Laparosc Endosc Surg 4:17
Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171(1):80–84
Eid GM, Collins J (2005) Application of a trocar wound closure system designed for laparoscopic procedures in morbidly obese patients. Obes Surg 15(6):871–873