Enhanced-view totally extraperitoneal repair in a patient with incisional hernia after robot-assisted laparoscopic radical prostatectomy: a case report

Shusaku Honma,Teppei Murakami,Keisuke Tanino,Takatsugu Kan,Takashi Kumode,Takehisa Harada,Siyuan Yao,Sanae Nakajima,Ryosuke Mizuno,Yugo Matsui

doi:10.1186/s40792-022-01380-2

Shusaku Honma, Teppei Murakami + Show 8 more

Open Access

https://doi.org/10.1186/s40792-022-01380-2

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Journal: Surgical Case Reports	Publication Date: Feb 7, 2022
Citations: 1	License type: open-access

Affiliation: Kobe City Medical Center West Hospital

Abstract

BackgroundAlthough laparoscopic incisional hernia repair, especially laparoscopic intraperitoneal onlay mesh, is a widely used technique, it can cause serious complications, including mesh erosion, adhesive bowel obstruction, and chronic pain. The enhanced-view totally extraperitoneal (eTEP) technique has been reported to prevent such complications by placing the mesh in the retrorectus space. Here, we report the case of a patient with post-robot-assisted laparoscopic radical prostatectomy (RARP) incisional hernia repaired using the eTEP technique.Case presentationA 67-year-old man, who underwent RARP for prostate cancer 4 years ago developed an incisional hernia. Abdominal computed tomography showed the presence of an epigastric incisional hernia measuring 4 cm long and 3.7 cm wide. We performed an eTEP repair. We closed the hernia defect using a 0 barbed suture and placed a self-gripping mesh measuring 20 cm long and 15 cm wide in the developed retrorectus space with no fixation. There were no postoperative complications, and the patient was discharged on postoperative day 2.ConclusionseTEP repair is considered an extremely effective surgical treatment option for incisional hernias because of its few resulting postoperative mesh-and-tacker-related complications.

Highlights

Laparoscopic incisional hernia repair, especially laparoscopic intraperitoneal onlay mesh, is a widely used technique, it can cause serious complications, including mesh erosion, adhesive bowel obstruction, and chronic pain
To the best of our knowledge, no other study has reported a case of enhanced-view totally extraperitoneal (eTEP) repair in a patient with incisional hernia after robot-assisted laparoscopic radical prostatectomy (RARP)
Recent large sample size cohort studies reported that the incisional hernia incidence rate was higher with minimally invasive radical prostatectomy, including RARP, than with traditional open radical prostatectomy [3, 4]

Summary

Introduction

Laparoscopic incisional hernia repair, especially laparoscopic intraperitoneal onlay mesh, is a widely used technique, it can cause serious complications, including mesh erosion, adhesive bowel obstruction, and chronic pain. Conclusions: eTEP repair is considered an extremely effective surgical treatment option for incisional hernias because of its few resulting postoperative mesh-and-tacker-related complications. Honma et al Surgical Case Reports (2022) 8:28 able to avoid common mesh-and-tacker-related complications from laparoscopic intraperitoneal onlay mesh (IPOM) technique, i.e., mesh erosion, adhesive bowel obstruction, and chronic pain, by placing the mesh in the retrorectus space [7].

Results

Conclusion