Case Report

J Minim Invasive Surg 2015; 18(4): 137-140

Published online December 15, 2015

https://doi.org/10.7602/jmis.2015.18.4.137

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

Trocar Site Hernia after Use of an 8-mm Bladeless Trocar in Robotic Colorectal Surgery

Dae Ro Lim, M.D., Hyuk Hur, M.D., Byung Soh Min, M.D., Seung Hyuk Baik, M.D., Nam Kyu Kim, M.D.

Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Port site hernias are a rare complication after laparoscopic and robotic surgery. The current case is an 8-mm port site hernia which occurred after robot-assisted colorectal surgery. A 70-year-old female with a BMI (body mass index) of 25.7 was diagnosed as rectosigmoid colon cancer. She underwent a robot-assisted low anterior resection with double-stapled anastomosis for AJCC (American Joint Committee on Cancer) stage IIIB. After the main procedure, fascial defects in the supra-pubic and the supra-umbilical site were closed with a routine procedure (12 mm). Thirty two months after surgery, she developed an incisional hernia in the left mid abdomen (8-mm port). Recognition of the potential for a port site hernia using an 8-mm bladeless trocar port as well as a 12-mm port is essential in robotic surgery. Patients with risk factors for a port site hernia may require complete port site closure.

Keywords Low anterior resection, Incisional hernia, Robotic surgery

  1. Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol 1994;84:881-884.
    CrossRef
  2. Tonouchi H, Ohmori Y, Kobayaschi, Kusunoki M. Trocar site hernia. Arch Surg 2004;139:1248-1256.
    Pubmed CrossRef
  3. Owens M, Barry M, Januua AZ, Winter DC. A systemic review of laparoscopic port site hernias in gastrointestinal surgery. The Surgeon 2011;9:218-924.
    Pubmed CrossRef
  4. Lumley J, Stitz R, Stevenson A, Fielding G, Luck A. Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum 2002;45:867-872.
    Pubmed CrossRef
  5. Fuller A, Fernandez A, Pautler SD. Incisional hernia after robot- assisted radical prostatectomy predisposing factors in a prospective cohort of 250 cases. Journal of Endourology 2011;24:1021-1024.
    Pubmed CrossRef
  6. Sanz-Lopez R, Martinez-Ramos C, Nunez-Pena JR, Ruiz de Gopegui M, Pastor-Sirera L, Tamames-Escobar S. Incisional hernias after laparoscopic vs open cholecystectomy. Surg Endosc 1999;13:922-924.
    Pubmed CrossRef
  7. Chiong E, Hegarty PK, Davis JW, Kamat AM, Pisters LL, Martin SF. Port-site hernias occurring after the use of bladeless radially expanding trocars. Urology 2010;75:574-580.
    Pubmed CrossRef
  8. Seamon LG, Backes DF, Resnick K, Cohn DE. Robotic trocar site small bowel evisceration after gynecologic cancer surgery. Obstet Gynecol 2008;112:462-4.
    Pubmed CrossRef
  9. Park MG, Kang JK, Kim JY, Hur H, Min BS, Lee KY, Kim NK. Trocar site hernia after the use of 12-mm bladeless trocar in robotic colorectal surgery. Surg Laparosc Endo Percutan Tech 2012;22:34-36.
    Pubmed CrossRef
  10. Kang DI, Woo SH, Lee DH, Kim IY. Incidence of port site hernias after robot assisted radical prostatectomy with the fascial closure of only the midline 12-mm port site. Journal of endourology 2012; 26:848-851.
    Pubmed CrossRef

Article

Case Report

J Minim Invasive Surg 2015; 18(4): 137-140

Published online December 15, 2015 https://doi.org/10.7602/jmis.2015.18.4.137

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

Trocar Site Hernia after Use of an 8-mm Bladeless Trocar in Robotic Colorectal Surgery

Dae Ro Lim, M.D., Hyuk Hur, M.D., Byung Soh Min, M.D., Seung Hyuk Baik, M.D., Nam Kyu Kim, M.D.

Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Port site hernias are a rare complication after laparoscopic and robotic surgery. The current case is an 8-mm port site hernia which occurred after robot-assisted colorectal surgery. A 70-year-old female with a BMI (body mass index) of 25.7 was diagnosed as rectosigmoid colon cancer. She underwent a robot-assisted low anterior resection with double-stapled anastomosis for AJCC (American Joint Committee on Cancer) stage IIIB. After the main procedure, fascial defects in the supra-pubic and the supra-umbilical site were closed with a routine procedure (12 mm). Thirty two months after surgery, she developed an incisional hernia in the left mid abdomen (8-mm port). Recognition of the potential for a port site hernia using an 8-mm bladeless trocar port as well as a 12-mm port is essential in robotic surgery. Patients with risk factors for a port site hernia may require complete port site closure.

Keywords: Low anterior resection, Incisional hernia, Robotic surgery

References

  1. Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol 1994;84:881-884.
    CrossRef
  2. Tonouchi H, Ohmori Y, Kobayaschi, Kusunoki M. Trocar site hernia. Arch Surg 2004;139:1248-1256.
    Pubmed CrossRef
  3. Owens M, Barry M, Januua AZ, Winter DC. A systemic review of laparoscopic port site hernias in gastrointestinal surgery. The Surgeon 2011;9:218-924.
    Pubmed CrossRef
  4. Lumley J, Stitz R, Stevenson A, Fielding G, Luck A. Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum 2002;45:867-872.
    Pubmed CrossRef
  5. Fuller A, Fernandez A, Pautler SD. Incisional hernia after robot- assisted radical prostatectomy predisposing factors in a prospective cohort of 250 cases. Journal of Endourology 2011;24:1021-1024.
    Pubmed CrossRef
  6. Sanz-Lopez R, Martinez-Ramos C, Nunez-Pena JR, Ruiz de Gopegui M, Pastor-Sirera L, Tamames-Escobar S. Incisional hernias after laparoscopic vs open cholecystectomy. Surg Endosc 1999;13:922-924.
    Pubmed CrossRef
  7. Chiong E, Hegarty PK, Davis JW, Kamat AM, Pisters LL, Martin SF. Port-site hernias occurring after the use of bladeless radially expanding trocars. Urology 2010;75:574-580.
    Pubmed CrossRef
  8. Seamon LG, Backes DF, Resnick K, Cohn DE. Robotic trocar site small bowel evisceration after gynecologic cancer surgery. Obstet Gynecol 2008;112:462-4.
    Pubmed CrossRef
  9. Park MG, Kang JK, Kim JY, Hur H, Min BS, Lee KY, Kim NK. Trocar site hernia after the use of 12-mm bladeless trocar in robotic colorectal surgery. Surg Laparosc Endo Percutan Tech 2012;22:34-36.
    Pubmed CrossRef
  10. Kang DI, Woo SH, Lee DH, Kim IY. Incidence of port site hernias after robot assisted radical prostatectomy with the fascial closure of only the midline 12-mm port site. Journal of endourology 2012; 26:848-851.
    Pubmed CrossRef

Metrics for This Article

Share this article on

  • kakao talk
  • line

Related articles in JMIS

Journal of Minimally Invasive Surgery

pISSN 2234-778X
eISSN 2234-5248