Port‐site incisional hernia from an 8‐mm robotic trocar following robot‐assisted radical cystectomy: Report of a rare case

INTRODUCTION: Port‐site incisional hernia is a rare but well‐known complication following a laparoscopic procedure and it may cause severe adverse outcomes, such as intestinal necrosis. Here, we report a rare case of hernia that occurred from an 8‐mm trocar after robot‐assisted radical cystectomy. CASE PRESENTATION: An 80‐year‐old woman was diagnosed with cT2bN1M0 bladder cancer. She underwent robot‐assisted radical cystectomy. Nine days after surgery, she complained of severe abdominal pain. Computed tomography showed herniation of small intestine. Emergency explorative laparotomy revealed herniation of small intestine from an 8‐mm trocar site. A section of the small bowel was necrotic and was resected. CONCLUSION: It is debatable whether we should routinely close the fascia of an 8‐mm trocar site. The patient was an elderly woman with multiple major abdominal surgery histories and hernia risk factors. For these patients, fascial closure of the 8‐mm trocar site may be indicated.