Incidence, Predictive Factors and Preventive Measures for Inguinal Hernia following Robotic and Laparoscopic Radical Prostatectomy: A Systematic Review

Abstract

Inguinal hernia is a known sequel of radical prostatectomy which contributes to patient morbidity and health care expenditure. In this systematic review we evaluated the incidence of inguinal hernia associated with minimally invasive radical prostatectomy, in addition to predictive factors and preventive measures. Materials and Methods: We searched PubMedÒ and EmbaseÒ between 2000 and February 2018 using the search terms inguinal hernia and radical prostatectomy. Results: In concordance with search terms and selection criteria we identified a total of 155 reports with 27 studies eligible for inclusion. Collated results demonstrated a variable prevalence of inguinal hernia after laparoscopic radical prostatectomy and robotic assisted radical prostatectomy ranging from 4.3% to 8.3% and from 3% to 19.4 %, respectively. There was a higher mean prevalence of inguinal hernia after robotic assisted prostatectomy. Factors predicting inguinal hernia following minimally invasive radical prostatectomy included low body mass index, poor stream and straining prior to prostatectomy detected on symptom score instruments, a patent processus vaginalis or an intraoperative incidental inguinal hernia. Herniotomy or herniorrhaphy with onlay mesh repair was the most commonly reported intraoperative repair technique at the time of minimally invasive radical prostatectomy. Recurrence of repaired incidental hernia is rare. Conclusions: Inguinal hernia is common after minimally invasive radical prostatectomy. There is a lack of high level evidence to clarify risk factors and preventive strategies for inguinal hernia after minimally invasive radical prostatectomy. There is a justification for randomized controlled trials to further evaluate this under recognized clinical problem.

Ambulatory robot‐assisted laparoscopic radical prostatectomy with extended recovery by total extraperitoneal approach

“…17 However, this risk was also associated with surgeon's experience, patient's BMI and performance of nerve sparing. 18 In the present study, there was no report of postoperative inguinal hernia occurrences in both the TEP cohorts.…”

Robotic inguinal hernia repair: systematic review and meta‐analysis

“…Although the first to utilize the robotic system to repair inguinal hernias were urologists, during robotic prostatectomy procedure, general surgeons have quickly taken this advanced technique to their armament 10,11 . The first robotic series published was described in 2015 in France; however since then, the number of centres have risen significantly reporting their outcomes 12 .…”

Application Effect of Combining Image‐Text Communication‐Based Healthcare Education with Shifting of Attention on Child Patients Undergoing Inguinal Hernia Repair under General Anesthesia

“…(3) Image-text communication: during the perioperative period, color graphic cards were distributed to the child patients mainly for soothing their emotions, and attention was paid to increasing the preoperative intervention intensity and laying the groundwork for postoperative intervention; during the intervention process, the child patients could be accompanied and assisted by their parents (for child patients who could not read on their own, reading could be completed with the assistance of their parents). (4) Image-text communication contents: when setting and selecting the contents, those that were popular and easy to understand, vivid, and interesting and rich in color should be used, e g., the cartoon preferred by children, so as to arouse the children's interest; in case of resentment, crying and shouting, and other bad emotions, interesting images and texts were used to shift the child patients' attention, and at the same time, consolation was performed to relieve their bad emotions, more appreciation and encouragement were given, and one-hour intervention was conducted daily before surgery [ 10 ]. (5) After the child patients were awake after surgery, images, texts, audios, videos, and other materials were used to shift their attention, so as to perform intervention before they experienced possible discomforts such as pain, and such intervention could correspond to the preoperative intervention contents for enhancing patients' psychological preparation and confidence to face the discomforts; after that, when the children were awake, movies and music preferred by them were played daily for 2-3 h and 30 min—1 h of image-text communication could be conducted.…”

“…According to the subjective evaluation method and scale evaluation method (SAS and SDS) [ 10 ], child patients' psychological status was evaluated by psychological tests after surgery. Subjective evaluation method: with the companion of family members, child patients were taken to the treatment room for evaluation of psychological status, the room was kept quiet and comfortable, and the nursing personnel directly communicated with the child patients and their family members and obtained information through sensory perception to judge the nature and extent of the child patients' psychological state.…”