M. H. Zeb1, N. D. Naik1, T. K. Pandian1, A. Jyot1, H. Y. Saleem1, E. F. Abbott1, M. Monali1, E. H. Buckarma1, D. R. Farley1 1Mayo Clinic,Dept Of Surgery,Rochester, MN, USA
Introduction:
Robotically assisted radical prostatectomy (RARP) with concomitant robotic inguinal hernia repair is an alternative to performing either procedure in separate settings. The safety and outcome of performing these procedures concomitantly is not well documented. We aimed to assess our experience and identify risk of recurrent hernias and other postoperative complications specifically surgical
Methods:
We retrospectively analyzed all adult patients (age >18 years) who underwent RARP with concurrent robotic inguinal hernia repair from 2008 to 2016 at our institution. Patient characteristics and operative details were extracted from the medical records. Descriptive statistics were calculated for all demographic and clinical variables and were reported as mean ± standard deviation (SD), median with interquartile ranges (IQR) or as a proportion.
Results:
65 male patients were identified who underwent the concurrent procedures [mean age=63 (SD ±6), range=50-75 years, mean BMI=27.9 kg/m2]. Median follow-up was 357 days (IQR 94-1560). Mean ASA score was 2. Mean estimated blood loss was 216 mL (SD±162). Twenty two (33%) patients underwent bilateral repair and 43 (67%) patients underwent unilateral repair. No patient had a surgical site infection. Hematomas due to arterial bleeding in the obturator fossa from lymph node dissection required surgical evacuation in two patients. One patient developed a seroma in the inguinal region. In addition, two patients developed hematuria and one patient developed a transient bowel obstruction. A total of four patients developed post-procedure hernias, two of which were port site hernias within 1 year of the procedure while two were ipsilateral recurrent inguinal hernias.
Conclusion:
Concomitant robotic hernia repair with RARP appears to be safe and effective with a low incidence of the port site and recurrent hernias. However, more studies need to be done with a longer follow-up to assess the long term risk of developing these complications.