Lower incidence of inguinal hernia after radical prostatectomy using open gasless endoscopic single-site surgery

Abstract

Inguinal hernia is one of the long-term complications requiring surgical interventions after retropubic radical prostatectomy (RRP), and its incidence has been reported to range from 12 to 21%. The number of open gasless laparoendoscopic single-site surgery, especially minimum incision endoscopic radical prostatectomy (MIES-RRP) is increasing in Japan. The incidence of post-operative inguinal hernia was compared between conventional RRP and MIES-RRP. The medical records of 333 patients who underwent conventional RRP (n ¼ 214) or MIES-RRP (n ¼ 119) with pelvic lymphadenectomy at our hospital were retrospectively evaluated. There were no significant differences between the two groups in age, pre-operative PSA levels, or previous major abdominal surgery (cholecystectomy, gastrectomy and colectomy), appendectomy or inguinal hernia repair. MIES-RRP was carried out with a 5-8-cm lower abdominal midline incision. Inguinal hernia developed postoperatively in 41 (19%) of the 214 men undergoing conventional RRP during mean follow-up of 58 months (range: 7-60 months). In contrast, 7 (5.9%) of the 119 men receiving MIES-RRP, developed inguinal hernia during mean follow-up of 21 months (range: 13-31 months). The hernia-free survival was significantly higher after MIES-RRP than after conventional RRP (P ¼ 0.037). Our results suggest that MIES-RRP is less associated with post-operative inguinal hernia than conventional RRP.

Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy

“…We have previously reported the incidence of IH in patients undergoing minimum incision endoscopic retropubic radical prostatectomy (MIES-RRP) and ORRP [18]. The incidence of IH after radical prostatectomy may be comparable between RARP and ORRP, since accumulative incidence of IH in patients with ORRP were 9.3% at 1 year and 13.1% at 2 years.…”

Robot-assisted radical prostatectomy significantly reduced biochemical recurrence compared to retro pubic radical prostatectomy

“…We performed RRP using the retroperitoneal approach and RARP using the peritoneal approach, as previously described [ 9 , 10 ]. Cavernous nerve preservation was performed in limited patients with RRP.…”