Trocar site hernia development in patients undergoing robotically assisted or standard laparoscopic staging surgery for endometrial cancer

Abstract

Objectives To compare the incidence and potential risk factors of trocar site hernia formation in women undergoing robotically assisted versus standard laparoscopic staging (RBT vs. LSC, respectively) for endometrial cancer. Methods We retrospectively identified all patients who underwent MIS staging for endometrial cancer at our institution from 01/09–12/12. Data collection involved the review of all operative notes, postoperative follow-up visit notes, and postoperative imaging reports. Appropriate statistical tests were used. Results We identified 760 eligible patients (LSC, 193; RBT, 567). The overall median age was 61 years (range, 33–90). The median BMI was 28.5 kg/m2 for LSC (range, 16.6–67.6) and 29.5 kg/m2 for RBT (range, 17.9–66) patients (p=0.8). A trocar site hernia developed in 16 patients (2.1%)—5 (2.6%) of 193 LSC and 11 (1.9%) of 567 RBT patients (p=0.6). Median time to hernia diagnosis was 13 (range, 5–20.5) and 18 months (range, 3–49), respectively (p=0.5). All hernias in the LSC cohort developed at the camera trocar site. In the RBT cohort, 10 developed at the camera trocar site and 1 at a lateral trocar site. Only BMI was associated with the development of hernias. A hernia was diagnosed in 7 (6.9%) of 101 patients with a BMI ≥40 kg/m2 compared with 9 (1.4%) of 659 with a BMI <40 kg/m2 (p=0.001). Conclusion MIS for endometrial cancer is associated with a low rate of trocar site hernia formation, with similar rates associated with RBT and standard LSC. Higher BMI is associated with the development of postoperative trocar site hernias.

Risk Factors for the Development of Incisional Hernia in Mini-laparotomy Wounds Following Laparoscopic Distal Gastrectomy in Patients with Gastric Cancer

“…In the present study with a median follow-up of 58 months, the incidence of IH in mini-laparotomy wounds after laparoscopic gastrectomy in patients with gastric cancer was 2.8% (16/565 patients). This incidence was similar to that previously reported after laparoscopic sleeve gastrectomy [6] or laparoscopic staging surgery for endometrial cancer [12]. However, it was lower than that reported after laparoscopic colorectal surgery [5].…”

Effects of Quantitative Nursing Combined with Psychological Intervention in Operating Room on Stress Response, Psychological State, and Prognosis of Patients Undergoing Laparoscopic Endometrial Cancer Surgery

“…Exclusion criteria [ 7 ] are (1) tumor metastasis has occurred, (2) together with other cancerous tumors, (3) combination of cardiovascular and cerebrovascular illness, (4) liver and kidney dysfunction, and (5) confusion or cognitive impairment.…”

Natural History of Radiologic Incisional Hernia Following Robotic Nephrectomy

“…Our results are in the same line as previous studies that mainly included nonurologic surgeries and reported the incidence of 0% to 5.2%. 5,22 There are few studies in urology literature reporting clinical IH. Carlsson et al using the Surveillance, Epidemiology, and End Results (SEER)-Medicare data set reported the frequency of IH repair of 5.3% after minimally invasive radical prostatectomy in a median follow-up of 3.1 years.…”