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Robotic-assisted repair of perineal hernia after extralevator abdominoperineal resection

  • J. MaurissenEmail author
  • M. Schoneveld
  • E. Van Eetvelde
  • M. Allaeys
Technical Advances
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Introduction

Perineal hernia is considered to be a rare complication after abdominoperineal resection (APR). However, its true incidence may be higher because of under-reporting. Moreover, there has been a recent change in technique from conventional to extralevator APR (eAPR) for oncological reasons. As the eAPR procedure creates a much wider perineal defect, a significant increase in incidence can be expected in the future. Recent reports show an incidence of 26% after eAPR [1].

Currently, there is no gold standard technique for perineal hernia repair, although various methods have been described.

In this paper, we present our strategy of a robotic-assisted repair using a synthetic mesh and we perform a narrative review of the literature.

Robotic-assisted hernia repair

A 39-year-old female attended our outpatient ward with complaints of sharp perineal pain, causing difficulty sitting and walking. She also noticed a tender perineal swelling that was progressive over time. There were...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was in accordance with the ethical standards of the UZ Brussel and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was given by the patient both written and orally.

References

  1. 1.
    Sayers AE, Patel RK, Hunter IA (2015) Perineal hernia formation following extralevator abdominoperineal excision. Colorectal Dis 17(4):351–355.  https://doi.org/10.1111/codi.12843 CrossRefGoogle Scholar
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    Balla A, Batista Rodríguez G, Buonomo N et al (2017) Perineal hernia repair after abdominoperineal excision or extralevator abdominoperineal excision: a systematic review of the literature. Tech Coloproctol 21:329–336.  https://doi.org/10.1007/s10151-017-1634-8 CrossRefGoogle Scholar
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    Musters GD, Klaver CEL, Bosker RJI et al (2017) Biological mesh closure of the pelvic floor after extralevator abdominoperineal resection for rectal cancer: a multicenter randomized controlled trial (the BIOPEX-study). Ann Surg 265(6):1074–1081.  https://doi.org/10.1097/SLA.0000000000002020 CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • J. Maurissen
    • 1
    Email author
  • M. Schoneveld
    • 1
  • E. Van Eetvelde
    • 1
  • M. Allaeys
    • 1
  1. 1.Department of Abdominal SurgeryUniversitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrusselsBelgium

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