title: Herniation formation in women undergoing robotically assisted laparoscopy or laparotomy for endometrial cancer.
abstract: OBJECTIVE
  To compare the incidence of trocar site hernia in women who underwent robotically assisted laparoscopic surgery (RBT) for endometrial cancer staging with the incidence of ventral hernia formation in patients who underwent laparotomy (LAP) for the same indication. To analyze risk factors for hernia formation in women undergoing RBT for endometrial cancer.
  
  
  METHODS
  We retrospectively identified all patients who underwent surgical staging for endometrial cancer via RBT or LAP from 2009-2012. Clinicopathologic data were analyzed. Appropriate statistical tests were used.
  
  
  RESULTS
  738 patients were staged via RBT (n=567) or LAP (n=171). Overall median age was 61 years (RBT range, 33-90; LAP range,28-86; p=0.4). Median BMI was 29.5 kg/m(2) (range, 17.9-66) and 30.3 kg/m(2) (range, 16.8-67.2), respectively (p=1.0). Eleven (1.9%) of 567 patients in the RBT cohort developed a trocar site hernia compared with 11 (6.4%) of 171 LAP patients who developed a ventral hernia (p=0.002). Median time to diagnosis was 18 months (range, 3-49) and 17 months (range, 7-30), respectively (p=0.7). Of the 11 RBT patients who developed a trocar site hernia, 10 (91%) were midline defects and 1 (9%) was a lateral defect of a prior inferior epigastric port site. No hernias required emergent operative intervention. Four (0.7%) of 567 RBT patients compared with 2 (1.2%) of 171 LAP patients required surgical hernia repair (p=0.4).
  
  
  CONCLUSIONS
  Trocar site herniation after RBT staging for endometrial cancer is uncommon and less likely to occur than ventral hernia formation with LAP staging. Furthermore, surgical revision rates are low.
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Schiavone
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Maciej S
authors.initials: MS
authors.lastname: Bielen
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Gardner
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Zivanovic
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Jewell
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Chi
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA. Electronic address: leitaom@mskcc.org.
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002277:Carcinoma / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology* / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology* / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D013997:Time Factors
keywords: Endometrial cancer; Gynecologic surgery; Laparotomy; Robotic surgery; Trocar site herniation; Ventral herniation