Acute Presentation of Port Site Hernia Following Robot-Assisted Hysterectomy

Sinha, Rooma; Rupa, Bana; Mohanty, Girija Shankar

doi:10.4103/jmh.jmh_23_21

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…86.6% had less than 24 hours of LOS and 13.4% patients stayed more than 24 hours but none beyond 72 hours. We had one case of readmission who presented as a port site hernia after RH and needed exploration with end-to-end anastomosis [6]. There was no urinary tract injury in this series.…”

Section: Resultsmentioning

confidence: 74%

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Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade

Sinha¹,

Rupa²,

Reddy³

2023

Gyne Robot Surg

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Objective: To analyse real time data over a decade of robotic surgery for benign Gynecological conditions using the da Vinci Si system.Methods: This is a retrospective analysis of prospectively collected data of da Vinci Si robotic surgery between August 2012 and July 2021 at single medical centre by a single surgeon.Results: Of the total 452 cases, the procedures were broadly categorised into myomectomy (RM-204), hysterectomy (RH-150), endometriosis excision (RE-80). The mean age of 46.12±6.77 and the mean BMI 28.89±5.02 kg/m2 in RH group was higher in RH group when compared to RM and RE groups. The mean docking time over 10 years was 10.59 minutes and mean console time was 96.35±47.77 minutes and both were significantly lower in the last 5 years when compared to first 5 years. 49.9% patients did not require intravenous analgesics beyond 24 hours and only 7.2% needed beyond 48 hours. 44.7% had less than 24 hours of hospital stay and 1.1% stayed beyond 48 hours. The mean hemoglobin drop was 1.109±0.7531 g%, significantly higher in RM group. The mean specimen weight in RM group was 323.8 g (200–1,372 g) and 84 cases had multiple leiomyomas. The commonest indication of robotic surgery was fibroid uterus.Conclusion: Robotic surgery for benign gynecologic surgery feasible and safe. It has equivalent outcomes when compared to laparoscopic surgery and superior when compared with laparotomy. Using robots to reduce open and repeat surgery for injury corrections could translate to reductions in the over-all economic burden of treatment.

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Section: Resultsmentioning

confidence: 74%

“…They did not report any case of intra-operative hemorrhage, nerve injury, foreign bodies left in the peritoneal cavity, mechanical failure, or medical accidents. We did have one readmission for port site hernia on day 4 post operative day [6].…”

Section: Discussionmentioning

confidence: 97%

Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade

Sinha¹,

Rupa²,

Reddy³

2023

Gyne Robot Surg

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“…Sinha et al reported a case of acute TSH from the 8-mm trocar site following robotic hysterectomy and they suspected that the drain placement in the same port was one of the contributing factors. 13 They reviewed the literature, identifying 10 case reports of 8-mm TSH: nine of these with acute presentation, of which three following gynaecologic procedures, [14][15][16] five after urological surgery [17][18][19][20][21] and one after cholecystectomy 22 ; one case of 8mm TSH occurred 32 months after a lower anterior resection for rectal cancer. 23 TSH represents an uncommon complication following minimally invasive surgery, whose incidence varies from 0.1% to 2%.…”

Section: Resultsmentioning

confidence: 99%

Robotic 8‐mm trocar fascial wounds: To close or not to close?

Milone,

Anoldo,

Manigrasso

et al. 2024

Robotics Computer Surgery

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BackgroundThe aim of this study was to investigate 8‐mm robotic trocar site hernia (TSH) rate over the short and long term, providing aids to manage the related fascial wounds.MethodsA retrospective analysis of 320 patients undergoing robotic surgery was conducted. The primary outcome was 8‐mm TSH rate with a minimum follow‐up of 12 months. The secondary outcome was the rate of haematomas and infections related to 8‐mm wounds and their association with patient comorbidities and trocar position.ResultsOne case of TSH was observed (0.31%). There were 15 cases of wound infection (4.68%) and 22 cases of wound haematoma (6.87%). Trocar related complications were significantly associated with patient comorbidities, not with trocar position.ConclusionsOur results do not justify the 8‐mm fascial wound closure. Data concerning the association between trocar‐related complications and patient comorbidities strengthen the need to implement the control of metabolic state and correct administration of perioperative therapy in high‐risk patients.

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“…Secondly, using the same instruments to perform multiple functions, such as using pro grasp forceps for both retraction and needle holders, reduces consumables costs. The overall minor complications such as port site discomfort/pain and minimal bleeding during surgery were <2%, and major complications such as port site hernia, bowel injury/bowel ischemia/gangrene, or massive bleeding due to vessel injury were <1% [ 26 ]. Acceptable low morbidity and complications were seen in the current study and have been similarly reported in the literature [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Multi-Institutional Trends in Gynecological Robotic Surgery in India: A Real-World Scenario

Sinha¹,

Jain²,

Sp³

et al. 2023

Cureus

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BackgroundRobot-assisted laparoscopic surgery in gynecology has grown exponentially compared to laparoscopic surgery. The probable reasons for the increased uptake of robotics are a shorter learning curve, threedimensional vision, and increased dexterity compared to laparoscopic surgery, and precise surgery as compared to open surgery. This study compares the time trends of various parameters in robotic gynecological surgery in India over a decade. Material and methodsIn India, a retrospective analysis of all robot-assisted laparoscopic surgery for gynecologic diseases in five tertiary care hospitals was conducted between July 2011 and June 2021. Data were collected regarding demographic profiles, clinical and disease characteristics, and indications for surgery. Details related to surgery were collected, such as the number of ports, console and docking time, the procedure performed, total operative time, average blood loss, blood transfusion, and length of hospital stay. All the parameters collected were grouped into five years, and a comparison was made between the first five years (2011)(2012)(2013)(2014)(2015) and the second five years (2016)(2017)(2018)(2019)(2020)(2021). Statistical analysis, including descriptive statistics and trend analysis, was performed. ResultsDuring the 10 years, the total number of cases included was 1,501, out of which 764 were benign cases and 737 were pre-malignant/malignant cases. The common indications were uterine leiomyoma (31.2%) and carcinoma endometrium (28%). The mean age for benign cases was significantly lower than that for malignant cases (40.84 years and 55.42 years, respectively). Mean blood loss was significantly lower for benign indications (97.48 mL) than for oncological surgery (184.67 mL) and needed fewer transfusions. The mean length of stay (LOS) for benign (2.07 days) and malignant/ pre-malignant cases (2.32 days) and the mean BMI for benign (28.40) and for oncological patients (28.47) were similar in both groups. The docking time reduced significantly in the last five years. ConclusionThe current retrospective study demonstrates an increasing uptake of robotic technology in gynecological surgery in India. Of the total cohort of cases, 70.9% of patients underwent gynecological robotic surgery in the last five years. A burst of adaptability happened for malignant cases in 2017 and benign cases in 2018, probably due to the increased availability of robotic platforms and improved awareness of technology and training among medical professionals. The number of cases has grown exponentially over the last five years in both benign and malignant/ pre-malignant scenarios; however, there has been a downward trend in the robotic surgery performed in the previous couple of years due to the uncertainty of the COVID pandemic.

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Acute Presentation of Port Site Hernia Following Robot-Assisted Hysterectomy

Cited by 5 publications

References 13 publications

Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade

Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade

Robotic 8‐mm trocar fascial wounds: To close or not to close?

Multi-Institutional Trends in Gynecological Robotic Surgery in India: A Real-World Scenario

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