title: Predictors of incisional hernia after robotic assisted radical prostatectomy.
abstract: Introduction. To explore the long term incidence and predictors of incisional hernia in patients that had RARP. Methods. All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair. Results. Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams; P = 0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480); P = 0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias. Conclusion. Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA.
authors.forename: Avinash
authors.initials: A
authors.lastname: Chennamsetty
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA ; Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Hafron
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Edwards
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Pew
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
authors.forename: Behdod
authors.initials: B
authors.lastname: Poushanchi
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA ; Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Hollander
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Killinger
authors.affiliation: Beaumont Health System, Department of Biostatistics, Research Institute, Royal Oak, MI 48073, USA.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Coffey
authors.affiliation: Beaumont Health System, Department of Urology, Royal Oak, MI 48073, USA ; Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Peters