TOPLINE

In patients with prostate cancer treated with robotic prostate removal, incisional hernias occurred less often when the incision was made through the side abdominal muscle than above the belly button.

METHODOLOGY

• Researchers analyzed data from 914 patients (median age, 66 years) with prostate cancer who underwent robot‑assisted laparoscopic radical prostatectomy at a German center between 2018 and 2020. They compared occurrence of hernia at two incision sites. 
• The incisions were made just above the belly button in 439 patients (supraumbilical group) and to the side of the midline through the rectus muscle in 475 patients (off-midline group). 
• The primary endpoint was the need for the repair of an incisional hernia, which was assessed using a patient questionnaire and review of records.

TAKEAWAY

• Over a median follow-up duration of nearly 3 years, a higher proportion of patients in the supraumbilical group than in the off‑midline group developed an incisional hernia (9.5% vs 1.7%; P < .001). 
• The supraumbilical extraction site was associated with 5.4-fold higher odds of developing an incisional hernia than the off‑midline site (P < .001). 
• The median time to hernia repair was longer in the supraumbilical group than in the off‑midline group (10.1 vs 0.5 months; P = .026). 

IN PRACTICE

“Our results stress the importance of adherence to the recommendations of the Hernia Societies, which is to avoid a supraumbilical specimen extraction site, also in terms of RALP [robot-assisted laparoscopic radical prostatectomy],” the researchers wrote.

SOURCE

The study was led by Jonathan Vollemaere of University Medical Centre Saarland and Saarland University in Homburg, Germany. It was published online on August 5 in BJU International.

LIMITATIONS

Patients in the supraumbilical group were operated earlier and had a longer follow-up duration than those in the off-midline group. Patients were not randomly assigned. Hernias were not assessed with clinical examination.

DISCLOSURES

The authors did not report any source of funding or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.