title: Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy.
abstract: BACKGROUND
  To evaluate the incidence and risk factors for postoperative inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) and to assess whether a newly developed prevention technique reduces the incidence of IH after RARP.
  
  
  METHODS
  We included 161 consecutive patients (322 groins) who underwent RARP between September 2011 and October 2013. The prevention technique was as follows: (1) sufficient incision of peritoneum around the internal inguinal ring; (2) separation of spermatic vessels; (3) dissection of vas deferens.
  
  
  RESULTS
  Postoperative IH occurred in 14 cases (19.4%) occurring in the observation group compared to 2 cases (2.2%) in the prevention group. Patent processus vaginalis (PPV) was the only risk factor. Time-to-event analysis demonstrated a significant decrease in IH incidence in the IH prevention group (p = 0.005).
  
  
  CONCLUSIONS
  Our data reveal a higher incidence of IH after RARP, with the existence of PPV as the only identified risk factor. Our simple IH-prevention technique, which does not involve the use of artificial materials, appears safe and effective.
authors: Department of Urology, St. Luke's International Hospital, Tokyo, Japan.
authors: Masaki
authors: M
authors: Shimbo
authors: Fumiyasu
authors: F
authors: Endo
authors: Kazuhito
authors: K
authors: Matsushita
authors: Toshihisa
authors: T
authors: Iwabuchi
authors: Akiko
authors: A
authors: Fujisaki
authors: Yoko
authors: Y
authors: Kyono
authors: Kohsuke
authors: K
authors: Hishiki
authors: Osamu
authors: O
authors: Muraishi
authors: Kazunori
authors: K
authors: Hattori
mesh_terms: D000368:Aged; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*