A Study of Inguinal Hernia after Robot-assisted Laparoscopic Radical Prostatectomy in Our Hospital

Abstract

Objective and methods : Robot-assisted laparoscopic radical prostatectomy (RALP) for prostate cancer has become a standard procedure, and the number of cases of this procedure has increased. Indirect inguinal hernia is a late complication of radical prostatectomy. We retrospectively evaluated 204 patients who underwent RALP at our hospital between April 2012 and December 2016. We examined the risk factors of and the preventive measures for inguinal hernia after RALP.

Results : The mean follow-up period after RALP was 645 days. Twenty-four patients with 27 lesions developed an inguinal hernia postoperatively. Twenty patients with 23 lesions who underwent hernioplasty developed an indirect inguinal hernia. As the internal inguinal ring was difficult to peel off owing to its strong adhesion due to the influence of RALP, the plug method was used in the reconstruction. In the case of an anatomical change in the internal inguinal ring, postoperative inguinal hernia developed in 17.8% of the patients, and in 12.8% patients, it developed even after isolation of the spermatic cord.

Conclusion : Inguinal hernia that develops after RALP is indirect hernia, for which the use of the plug method in reconstruction is reasonable. If intraoperative findings during RALP indicate an anatomical change in the internal inguinal ring, the possibility of postoperative inguinal hernia and prophylactic procedures should be considered. However, the preventive effect of isolation of the spermatic cord remains questionable.