Journal of Robotic Surgery

, 3:187 | Cite as

Port-site complications after pediatric urologic robotic surgery

  • Ashley Tapscott
  • Steven S. Kim
  • Shawn White
  • Reid Graves
  • Kate Kraft
  • Pasquale Casale
Original Article


The incidence of port-site hernia development after adult laparoscopic surgery is reported to be between 0.1% and 3.0%. There are no published reports concerning hernia incidence or related factors after pediatric urologic laparoscopic interventions. We present our experience with port-site complications following pediatric urologic robotic surgery (PURS). From July 2005 to June 2009 we prospectively followed the first 200 PURS cases performed at Children’s Hospital of Philadelphia. All cases had follow-up available for at least 2 months postoperatively. The data collected allowed for evaluation of the outcomes for each port site separately and compared its size, location, and fascial closure status. Median age was 3.2 years (0.4–18.8 years). All 200 patients had follow-up with median of 11 months (0.2–83.4 months). There were 600 port sites analyzed in the 200 cases. Of the 600 port sites, 200 were umbilical. The other 400 port sites were lateral to the rectus muscle, either subcostal or at the level of the anterior superior iliac spine. There was no wound irrigation prior to closure on any sites. All the patients received perioperative antibiotics. One umbilical port had a hernia diagnosed 2 weeks postoperatively. Four of the 600 ports (0.6%) developed skin dehiscence secondary to superficial wound infection within 1 week postoperatively. At our institution, the overall incidence of port-site complications after PURS was 0.83%. This is slightly lower than the published incidence in adults undergoing conventional laparoscopy. Due to the low incidence of complications it is difficult to draw conclusions on contributing factors.


Pediatric Laparoscopy Urology Child Robotic surgery Infection Hernia 



Body mass index


Minimally invasive surgery


Pediatric urologic robotic surgery



No funding or sponsors were used in the production of this manuscript.

Conflict of interest statement

None of the authors of this manuscript have any financial or personal relationships to disclose that could inappropriately influence or bias our work.


  1. 1.
    Varela JE, Wilson SE, Nguyen NT (2009) Laparoscopic surgery significantly reduces surgical-site infections compared with open surgery. Surg EndoscGoogle Scholar
  2. 2.
    Senagore AJ, Stulberg JJ, Byrnes J, Delaney CP (2009) A national comparison of laparoscopic vs. open colectomy using the National Surgical Quality Improvement Project data. Dis Colon Rectum 52(2):183–186PubMedGoogle Scholar
  3. 3.
    Kim BS, Yoo ES, Kwon TG (2009) Complications of transperitoneal laparoscopic nephrectomy: a single-center experience. Urology 73(6):1283–1287CrossRefPubMedGoogle Scholar
  4. 4.
    Sanz-Lopez R, Martinez-Ramos C, Nunez-Pena JR et al (1999) Incisional hernias after laparoscopic vs open cholecystectomy. Surg Endosc 13:922CrossRefPubMedGoogle Scholar
  5. 5.
    Mahmoud Uslu HY, Ustuner EH, Sozener U et al (2007) Cannula site insertion technique prevents incisional hernia in laparoscopic fundoplication. Surg Laparosc Endosc Percutan Tech 17:267CrossRefPubMedGoogle Scholar
  6. 6.
    Casale P (2008) Robotic pediatric urology. Expert Rev Med Devices 5(1):59–64CrossRefPubMedGoogle Scholar
  7. 7.
    Waldhaussen JH (1996) Incisional hernia in a 5-mm trocar site following pediatric laparoscopy. J Laparoendosc Surg 6(Suppl 1):S89PubMedGoogle Scholar
  8. 8.
    Passerotti CC, Nguyen HT, Retik AB, Peters CA (2008) Patterns and predictors of laparoscopic complications in pediatric urology: the role of ongoing surgical volume and access techniques. J Urol 180(2):681CrossRefPubMedGoogle Scholar
  9. 9.
    Rescorla FJ, West KW, Engum SA et al (2007) Laparoscopic splenic procedures in children: experience in 231 children. Ann Surg 246:683CrossRefPubMedGoogle Scholar
  10. 10.
    Paya K, Wurm J, Fakhari M et al (2008) Trocar-site hernia as a typical postoperative complication of minimally invasive surgery among preschool children. Surg Endosc 22:2724CrossRefPubMedGoogle Scholar
  11. 11.
    Mark SD (1995) Omental herniation through a small laparoscopic port. Br J Urol 76:137CrossRefPubMedGoogle Scholar
  12. 12.
    Yee DS, Duel BP (2006) Omental herniation through a 3-mm umbilical trocar site. J Endourol 20:133CrossRefPubMedGoogle Scholar
  13. 13.
    Peters CA (1996) Complications in pediatric urological laparoscopy: results of a survey. J Urol 155:1070CrossRefPubMedGoogle Scholar
  14. 14.
    Perissat J, Collet DR, Belliard R (1989) Gallstones: laparoscopic treatment, intracorporeal lithotripsy followed by cholecystostomy or cholecystectomy—a personal technique. Endoscopy 21(Suppl 1):373CrossRefPubMedGoogle Scholar
  15. 15.
    Di Vita G, Frazzetta M, Cortese E et al (1997) Laparocele after laparoscopic surgery. Minerva Chir 52:523PubMedGoogle Scholar
  16. 16.
    Kiilholma P, Makinen J (1988) Incarcerated Richter’s hernia after laparoscopy: a case report. Eur J Obstet Gynecol Reprod Biol 28:75CrossRefPubMedGoogle Scholar
  17. 17.
    Spice J (2008) Promoting healthy eating: the role of pre-operative assessment. Paediatr Nurs 20(4):14–18PubMedGoogle Scholar
  18. 18.
    Hering E, Pritsker I, Gonchar L, Pillar G (2009) Obesity in children is associated with increased health care use. Clin Pediatr (Phila)Google Scholar

Copyright information

© Springer-Verlag London Ltd 2009

Authors and Affiliations

  • Ashley Tapscott
    • 1
  • Steven S. Kim
    • 1
  • Shawn White
    • 1
  • Reid Graves
    • 1
  • Kate Kraft
    • 1
  • Pasquale Casale
    • 1
  1. 1.Children’s Hospital of PhiladelphiaUniversity of PennsylvaniaPhiladelphiaUSA

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