A Case of an 8-mm Port-site Small Bowel Incarceration following Robotic Rectal Cancer Surgery

Abstract

An 89-year-old woman underwent robotic Hartman's surgery for rectal cancer (cT3N0M0, cStage IIa). On the 6th postoperative day, nausea due to bowel obstruction appeared, and physical findings showed a golf-ball-sized bulge in the left side of the abdomen. A plain abdominal computed tomography (CT) revealed small bowel incarceration at the 8-mm port-site of the left abdomen, and it was diagnosed as the 8-mm port-site hernia. The herniated bowel was difficult to return manually, therefore emergency surgery was planned on the same day. Intraoperatively, the incarcerated small bowel and the hernia opening were identified. Since no herniated small bowel necrosis was observed, it was reduced to the abdominal cavity and the operation was completed with suturing fascia and peritoneum by 0-PDS. The patient's postoperative course was uneventful, and she was discharged 11 days after the emergency surgery. During 10 months of outpatient follow-up after discharge, no hernia recurrence has been observed. The port-site hernia is a specific complication of laparoscopic surgery, but there is no clear evidence on whether the 8-mm Da Vinci port-site should be closed in robotic surgery. In this report, we describe our experience with a case of the 8-mm port-site hernia following robotic rectal cancer surgery.