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Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy

Background: Trocar-site hernia (TSH) is an uncommon complication following laparoscopic surgery and a potential cause of significant morbidity if bowel incarceration or strangulation occurs. Lateral trocar sites are intrinsically less susceptible to hernia development and traditionally do not mandat...

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Autores principales: Kocher, Neil J., Ilinsky, Daniel, Raman, Jay D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665551/
https://www.ncbi.nlm.nih.gov/pubmed/29098201
http://dx.doi.org/10.1089/cren.2017.0099
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author Kocher, Neil J.
Ilinsky, Daniel
Raman, Jay D.
author_facet Kocher, Neil J.
Ilinsky, Daniel
Raman, Jay D.
author_sort Kocher, Neil J.
collection PubMed
description Background: Trocar-site hernia (TSH) is an uncommon complication following laparoscopic surgery and a potential cause of significant morbidity if bowel incarceration or strangulation occurs. Lateral trocar sites are intrinsically less susceptible to hernia development and traditionally do not mandate fascial closure. We present an unusual case involving an incarcerated TSH from a 12-mm right lateral port after robotic prostatectomy. Case Presentation: The patient is a 76-year-old man with localized intermediate risk, high-volume prostate cancer who underwent a robot-assisted, laparoscopic prostatectomy. He developed generalized malaise and no flatus or bowel movements at 7 days postoperatively. Cross-sectional imaging revealed small bowel dilatation with a transition point along the right lateral 12-mm trocar site. A minilaparotomy (extension of lateral port incision) confirmed incarcerated but viable small bowel. This was reduced and fascia closed without surgical resection. Conclusion: While rare, TSH is an important clinical entity to recognize after minimally invasive surgery. It is critical to properly review trocar technique and maintain a low threshold for close postoperative follow-up, if there is clinical concern for a trocar hernia.
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spelling pubmed-56655512017-11-02 Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy Kocher, Neil J. Ilinsky, Daniel Raman, Jay D. J Endourol Case Rep Case Report Background: Trocar-site hernia (TSH) is an uncommon complication following laparoscopic surgery and a potential cause of significant morbidity if bowel incarceration or strangulation occurs. Lateral trocar sites are intrinsically less susceptible to hernia development and traditionally do not mandate fascial closure. We present an unusual case involving an incarcerated TSH from a 12-mm right lateral port after robotic prostatectomy. Case Presentation: The patient is a 76-year-old man with localized intermediate risk, high-volume prostate cancer who underwent a robot-assisted, laparoscopic prostatectomy. He developed generalized malaise and no flatus or bowel movements at 7 days postoperatively. Cross-sectional imaging revealed small bowel dilatation with a transition point along the right lateral 12-mm trocar site. A minilaparotomy (extension of lateral port incision) confirmed incarcerated but viable small bowel. This was reduced and fascia closed without surgical resection. Conclusion: While rare, TSH is an important clinical entity to recognize after minimally invasive surgery. It is critical to properly review trocar technique and maintain a low threshold for close postoperative follow-up, if there is clinical concern for a trocar hernia. Mary Ann Liebert, Inc. 2017-10-01 /pmc/articles/PMC5665551/ /pubmed/29098201 http://dx.doi.org/10.1089/cren.2017.0099 Text en © Neil J. Kocher et al. 2017; Published by Mary Ann Liebert, Inc. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kocher, Neil J.
Ilinsky, Daniel
Raman, Jay D.
Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title_full Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title_fullStr Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title_full_unstemmed Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title_short Incarcerated Right Lateral Trocar-Site Hernia as a Rare Complication of Robot-Assisted Laparoscopic Prostatectomy
title_sort incarcerated right lateral trocar-site hernia as a rare complication of robot-assisted laparoscopic prostatectomy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665551/
https://www.ncbi.nlm.nih.gov/pubmed/29098201
http://dx.doi.org/10.1089/cren.2017.0099
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