Abstract
Robot-assisted radical prostatectomy (RARP) may be performed via an extraperitoneal (eRARP) or transperitoneal (tRARP) approach. There are no published studies comparing these two methods in patients with a history of prior inguinal hernia repair with mesh (IHRm), but the latter is often advocated in this setting. A retrospective review of patients who underwent RARP with prior IHRm who had a minimum follow-up of 3 months from July 1, 2003 to December 31, 2014 was undertaken. Of 2927 patients who underwent RARP for primary treatment of adenocarcinoma of the prostate, 286 patients had a clear history of IHRm. Of these, 116 patients underwent eRARP and 170 patients underwent tRARP. No differences were noted between the groups with respect to age, body mass index or American Society of Anesthesiology score. Patients in the tRARP group had higher D’Amico risk classification scores (p < 0.0001) and as such, underwent less nerve-sparing procedures (p < 0.0001) and had a higher rate of concomitant pelvic lymph node dissections (p < 0.0001). The tRARP group had a higher incidence of laparoscopic and bilateral IHRm. On univariate analysis, EBL was lower in the tRARP group (172.41 vs. 201.98, p = 0.05) but all other parameters were similar. After controlling for covariates using regression analysis with model selection, a trend was noted towards lower operating room time in the tRARP group (p = 0.0624) but no other differences were noted. The presence of prior IHRm does not seem to be a contraindication to eRARP. OR time may be lower with tRARP (trend) but all other quality indicators studied were similar.
Similar content being viewed by others
Abbreviations
- RP:
-
Radical prostatectomy
- RARP:
-
Robot-assisted radical prostatectomy
- eRARP:
-
Extraperitoneal robot-assisted radical prostatectomy
- tRARP:
-
Transperitoneal robot-assisted radical prostatectomy
- IHR:
-
Inguinal hernia repair
- IHRm:
-
Inguinal hernia repair with mesh
- BMI:
-
Body mass index
- ASA:
-
American society of anesthesiologists
- LN:
-
Lymph node
- EBL:
-
Estimated blood loss
- UTI:
-
Urinary tract infection
- OR:
-
Operating room
- TCR:
-
Time to catheter removal
- LOS:
-
Length of hospital stay
- PLND:
-
Pelvic lymph node dissection
References
Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29
Bill-Axelson A, Holmberg L, Garmo H, Rider JR, Taari K, Busch C et al (2014) Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med 370(10):932–942
Jackson MA, Bellas N, Siegrist T, Haddock P, Staff I, Laudone V et al (2016) Experienced open vs early robotic-assisted laparoscopic radical prostatectomy: a 10-year prospective and retrospective comparison. Urology 91:111–118
Smith JA, Herrell SD (2005) Robotic-assisted laparoscopic prostatectomy: do minimally invasive approaches offer significant advantages? J Clin Oncol 23(32):8170–8175
Novara G, Ficarra V, Rosen RC, Artibani W, Costello A, Eastham JA et al (2012) Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol 62(3):431–452
Chung SD, Kelle JJ, Huang CY, Chen YH, Lin HC (2012) Comparison of 90-day re-admission rates between open retropubic radical prostatectomy (RRP), laparoscopic RP (LRP) and robot-assisted laparoscopic prostatectomy (RALP). BJU Int 110(11 Pt C)):E966–E971
Boczko J, Madeb R, Golijanin D, Erturk E, Mathe M, Patel HR et al (2006) Robot-assisted radical prostatectomy in obese patients. Can J Urol 13(4):3169–3173
Katz EE, Patel RV, Sokoloff MH, Vargish T, Brendler CB (2002) Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. J Urol 167(2 Pt 1):637–638
Cook H, Afzal N, Cornaby AJ (2003) Laparoscopic hernia repairs may make subsequent radical retropubic prostatectomy more hazardous. BJU Int 91(7):729
Spernat D, Sofield D, Moon D, Louie-Johnsun M, Woo H (2014) Implications of laparoscopic inguinal hernia repair on open, laparoscopic, and robotic radical prostatectomy. Prostate Int 2(1):8–11
Al-Shareef AH, Akin Y, Almouhissen T, Rassweiler J, Alshehri MS, Gözen AS et al (2015) Effects of previous hernia repair on extraperitoneal robot-assisted radical prostatectomy: a matched-pair analysis study. J Endourol 29(10):1143–1147
Do HM, Turner K, Dietel A, Wedderburn A, Liatsikos E, Stolzenburg JU (2011) Previous laparoscopic inguinal hernia repair does not adversely affect the functional or oncological outcomes of endoscopic extraperitoneal radical prostatectomy. Urology 77(4):963–967
Stolzenburg JU, Ho KM, Do M, Rabenalt R, Dorschner W, Truss MC (2005) Impact of previous surgery on endoscopic extraperitoneal radical prostatectomy. Urology 65(2):325–331
Laungani RG, Kaul S, Muhletaler F, Badani KK, Peabody J, Menon M (2007) Impact of previous inguinal hernia repair on transperitoneal robotic prostatectomy. Can J Urol 14(4):3635–3639
Lee JY, Diaz RR, Cho KS, Choi YD (2013) Meta-analysis of transperitoneal versus extraperitoneal robot-assisted radical prostatectomy for prostate cancer. J Laparoendosc Adv Surg Tech A 23(11):919–925
Akand M, Erdogru T, Avci E, Ates M (2015) Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: a prospective single surgeon randomized comparative study. Int J Urol 22(10):916–921
Lee JY, Diaz RR, Cho KS, Yu HS, Chung JS, Ham WS et al (2013) Lymphocele after extraperitoneal robot-assisted radical prostatectomy: a propensity score-matching study. Int J Urol 20(12):1169–1176
Stolzenburg JU, Wasserscheid J, Rabenalt R, Do M, Schwalenberg T, McNeill A et al (2008) Reduction in incidence of lymphocele following extraperitoneal radical prostatectomy and pelvic lymph node dissection by bilateral peritoneal fenestration. World J Urol 26(6):581–586
Reynvoet E, Chiers K, Van Overbeke I, Troisi R, Berrevoet F (2015) Intraperitoneal mesh devices for small midline hernias: mesh behavior in a porcine model. Hernia 19(6):955–963
Erdogru T, Teber D, Frede T, Marrero R, Hammady A, Rassweiler J (2005) The effect of previous transperitoneal laparoscopic inguinal herniorrhaphy on transperitoneal laparoscopic radical prostatectomy. J Urol 173(3):769–772
Peeters E, Joniau S, Van Poppel H, Miserez M (2012) Case-matched analysis of outcome after open retropubic radical prostatectomy in patients with previous preperitoneal inguinal hernia repair. Br J Surg 99(3):431–435
Stolzenburg JU, Anderson C, Rabenalt R, Do M, Ho K, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 23(4):295–299
Acknowledgements
The author thanks Ingrid Mikk and Bonita Powell.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
David Horovitz, Changyong Feng, Edward M. Messing, Jean V. Joseph declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Horovitz, D., Feng, C., Messing, E.M. et al. Extraperitoneal vs. transperitoneal robot-assisted radical prostatectomy in patients with a history of prior inguinal hernia repair with mesh. J Robotic Surg 11, 447–454 (2017). https://doi.org/10.1007/s11701-017-0678-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11701-017-0678-0