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Are we failing to consent to an increasingly common complication? Incisional hernias at robotic prostatectomy

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Abstract

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.

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Authors and Affiliations

  1. Department of Urology, Austin Health, Heidelberg, VIC, Australia

    Brennan Timm, Ellen O’Connor, Damien Bolton & Peter Liodakis

  2. North Eastern Urology, Heidelberg, VIC, Australia

    Brennan Timm & Peter Liodakis

Authors
  1. Brennan Timm
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  2. Ellen O’Connor
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  3. Damien Bolton
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  4. Peter Liodakis
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Correspondence to Brennan Timm.

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Conflict of interest

No authors have any external funding or conflicts of interest to declare in the presentation of these works (Brennan Timm, Ellen O’Connor, Peter Liodakis, Damien Bolton).

Ethics approval

Ethics for Clinical audit of incisional hernia rates was obtained through Austin Health Office for Research against the principles of the National Statement on Ethical Conduct in Research (2007, updated 2018) HREC (Audit/20/Austin/20).

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All patients gave informed consent for their data to be included in the study and for de-identified data to be published.

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Timm, B., O’Connor, E., Bolton, D. et al. Are we failing to consent to an increasingly common complication? Incisional hernias at robotic prostatectomy. J Robotic Surg 14, 861–864 (2020). https://doi.org/10.1007/s11701-020-01063-w

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  • DOI: https://doi.org/10.1007/s11701-020-01063-w

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