A rare case of acute presentation of trocar site hernia from robot-assisted laparoscopic partial nephrectomy

  • Zi Qin Ng
  • Richard Pemberton
  • Patrick Tan
Case Report


Trocar site hernia is not a common acute complication encountered after robot-assisted surgery, especially in the urological cohort of patients. A few case reports of small bowel obstruction secondary to incarceration by trocar site hernia have been described in gynaecological surgery and prostatectomies. As the clinical presentation is non-specific, late diagnosis has significant implication on morbidity and mortality. Here, we present a rare case of a patient with recent robot-assisted laparoscopic partial nephrectomy for a renal cell carcinoma presented with features of impending bowel obstruction secondary to incarcerated small bowel in the trocar site. We also reviewed the literature focusing on clinical features of trocar site hernia and preventive measures.


Trocar Hernia Robot assisted Bowel obstruction Nephrectomy 


Authors’ contribution

Zi Qin NG designed the study, collected and analyzed the data, drafted the article and approved the final version of the article to be published. Richard PEMBERTON analyzed the data, critically reviewed the article and approved the final version of the article to be published. Patrick TAN co-designed the study, analyzed the data, critically reviewed the article, supervised the study and approved the final version of the article to be published.

Compliance with ethical standards

Conflict of interest

Authors ZN, RB and PT declare that they have no conflict of interest.

Statement of ethics

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975. Informed consent was obtained from the patient for being included in the study.

Consent section

Written informed consent was obtained from the patient for publication of this Case Report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.


  1. 1.
    Swank HA, Mulder IM, la Chapelle CF, Reitsma JB, Lange JF, Bemelman WA (2012) Systematic review of trocar-site hernia. Br J Surg 99(3):315–323CrossRefPubMedGoogle Scholar
  2. 2.
    Seamon LG, Backes F, Resnick K, Cohn DE (2008) Robotic trocar site small bowel evisceration after gynecologic cancer surgery. Obstet Gynecol 112(2 Pt 2):462–464CrossRefPubMedGoogle Scholar
  3. 3.
    Spaliviero M, Samara EN, Oguejiofor IK, DaVault RJ, Albrecht RM, Wong C (2009) Trocar site spigelian-type hernia after robot-assisted laparoscopic prostatectomy. Urology 73(6):1423CrossRefPubMedGoogle Scholar
  4. 4.
    Fuller A, Fernandez A, Pautler SE (2011) Incisional hernia after robot-assisted radical prostatectomy-predisposing factors in a prospective cohort of 250 cases. J Endourol 25(6):1021–1024CrossRefPubMedGoogle Scholar
  5. 5.
    Tsu JH, Ng AT, Wong JK, Wong EM, Ho KL, Yiu MK (2014) Trocar-site hernia at the 8 mm robotic port after robot-assisted laparoscopic prostatectomy: a case report and review of the literature. J Robot Surg 8(1):89–91CrossRefPubMedGoogle Scholar
  6. 6.
    Chiong E, Hegarty PK, Davis JW, Kamat AM, Pisters LL, Matin SF (2010) Port-site hernias occurring after the use of bladeless radially expanding trocars. Urology 75(3):574–580CrossRefPubMedGoogle Scholar
  7. 7.
    Ramalingam M, Senthil K, Murugesan A, Pai M (2012) Early-onset port site (drain site) hernia in pediatric laparoscopy: a case series. J Laparoendosc Adv Surg Tech A 22(4):416–418CrossRefPubMedGoogle Scholar
  8. 8.
    Chennamsetty A, Hafron J, Edwards L, Pew S, Poushanchi B, Hollander J et al (2015) Predictors of incisional hernia after robotic assisted radical prostatectomy. Adv Urol 2015:457305CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Christie MC, Manger JP, Khiyami AM, Ornan AA, Wheeler KM, Schenkman NS (2016) Occult radiographically evident port-site hernia after robot-assisted urologic surgery: incidence and risk factors. J Endourol 30(1):92–96CrossRefPubMedGoogle Scholar
  10. 10.
    Hubsher Chad, Talug Can, Trocar Salkini M (2014) Site herniation following robotic renal surgery in an obese population: a comparison of vicryl fascial closure and surgicel® plugs. J Urol 191(4S):e395CrossRefGoogle Scholar
  11. 11.
    Petros FG, Patel MN, Kheterpal E, Siddiqui S, Ross J, Bhandari A et al (2011) Robotic partial nephrectomy in the setting of prior abdominal surgery. BJU Int 108(3):413–419CrossRefPubMedGoogle Scholar
  12. 12.
    Lim SK, Kim KH, Shin TY, Hong SJ, Choi YD, Rha KH (2014) A rare case of interparietal incisional hernia from 8 mm trocar site after robot-assisted laparoscopic prostatectomy. Hernia 18(6):911–913CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgerySt John of God Subiaco HospitalSubiacoAustralia
  2. 2.Department of UrologySt John of God Subiaco HospitalSubiacoAustralia

Personalised recommendations