title: Incidence of port-site hernias after robot-assisted radical prostatectomy with the fascial closure of only the midline 12-mm port site.
abstract: OBJECTIVE
  Port-site hernias are rare complications that occur in approximately 1% of all laparoscopic surgeries. With the use of bladeless, blunt-tipped entry trocars, some surgeons have argued that not all port sites need fascial closure. Several cases of port-site hernia, however, have been reported recently with the use of bladeless trocars. This study evaluated the incidence of port-site hernias after robot-assisted radical prostatectomy (RARP) as we routinely closed the fascia of only the midline 12-mm port site.
  
  
  METHODS
  From 2006 to 2009, 498 patients with localized prostate cancer underwent RARP. Bladeless dilating trocars were used in all of our patients. Routinely, six ports were used: two 12 mm, three 8 mm, and one 5 mm. Fascial closure was performed only for the midline supraumbilical 12-mm port site.
  
  
  RESULTS
  In 498 cases of RARP, there were two port-site hernias (0.4%, 2/498). Both cases occurred at the midline supraumbilical 12-mm camera port site. No hernia developed at nonmidline port sites, including the lateral 12-mm port site.
  
  
  CONCLUSIONS
  Trocar site hernias after RARP are rare. When bladeless dilating trocars are used, routine closure of fascia of non-midline 12-mm or smaller port sites is not necessary. Splitting the muscle and fascia without cutting likely renders routine closure of fascia unnecessary for nonmidline ports that are ≤ 12 mm.
authors.affiliation: Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer, The Cancer Institute of New Jersey/Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Kang
authors.forename: Seung Hyo
authors.initials: SH
authors.lastname: Woo
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Isaac Yi
authors.initials: IY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000071938:Fasciotomy; D006555:Hernia, Ventral / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011468:Prostatectomy / Q000009:adverse effects*; D012371:Robotics / Q000379:methods*; D013525:Surgical Instruments / Q000009:adverse effects; D014472:Umbilicus / Q000473:pathology / Q000601:surgery