歐弦哲1,2,3 黃立華1 張光喜2 歐宴泉1,2 童敏哲1
童綜合醫院外科部泌尿外1 研究部2 台北榮總教學部，畢業後醫學訓練，陽明醫學大學3
Robotic Incisional Hernia Repair After Robotic-assisted
Radical Prostatectomy (RARP): A 3-port Approach
Hsien-Che Ou1,2,3 Li-Hua Huang1, Kuang-Hsi Chang3 ,Yen-Chuan Ou1,3 Min-Che Tung1
1Division of Urology, Department of Surgery, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C.;
2Department of Research, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C.;
3Post-graduate Year Training （PGY), Department of Medical Education, Taipei Veterans General Hospital,School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.;
Purpose: To report a case-series of 10 patients who underwent robotic assisted incisional hernia repair(RIHR) after robotic assisted radical prostatectomy(RARP). And aim to propose the feasibility of incisional hernia repair with da Vinci robotics.
Patient and Method: We recruit the patients from an observed group of 2000 consecutive patients who underwent RARP from December, 2005 to June, 2020 by a single surgeon. Patients’ characteristic included age, body mass index(BMI), PSA level, pathology Gleason score, and pathology TNM staging. The variants regarding patients’ incisional hernia included incisional hernia occurrence time after RARP, defect size, operation time, console time, blood loss, and follow-up time after the herniation occurrence. Furthermore, we established the defect size of 3x2 cm2 as the cutoff value for using mesh reinforcement or not.
Results: The mean defect area was 27.7 cm2, and the average operative time was 114.8 minutes with mean console time of 87 minutes. The blood loss was 32.5ml and all of the patient’s hospital stay was 3 days without complications. The mean follow-up period was 29.5 months without any recurrence. Conclusion: Robotic assisted incisional hernia repair is a feasible surgical method that showed no inferior to the traditional open or laparoscopic repair. It can possibly lessen surgeon’s and patient’s burden.