Robot-assisted laparoscopic repair of perineal hernia after abdominoperineal resection:A case report and review of the literature
| Autor: | Peiman Poornoroozy, Pooya Rajabaleyan, Per Vadgaard Andersen, Allan Dorfelt |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Synthetic mesh medicine.medical_treatment Article Da Vinci Surgical System 03 medical and health sciences 0302 clinical medicine Case report medicine Abdominoperineal resection Laparoscopy Perineal hernia Pelvis Neoadjuvant therapy Pelvic floor medicine.diagnostic_test business.industry Extralevator abdominoperineal excision Surgery surgical procedures operative medicine.anatomical_structure Robotic-assisted laparoscopic repair 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Presentation (obstetrics) business |
| Zdroj: | Rajabaleyan, P, Dorfelt, A, Poornoroozy, P & Vadgaard Andersen, P 2019, ' Robot-assisted laparoscopic repair of perineal hernia after abdominoperineal resection : A case report and review of the literature ', International Journal of Surgery Case Reports, vol. 55, pp. 54-57 . https://doi.org/10.1016/j.ijscr.2018.12.009 International Journal of Surgery Case Reports |
| DOI: | 10.1016/j.ijscr.2018.12.009 |
| Popis: | Highlights • Incidence of perineal hernia might be on the rise due to modification of operative technique and probably increased usage of neoadjuvant therapy. • Numerous approaches have been described for the repair of the defect, but none have yet been accepted as “Gold standard”. • To our knowledge this is the first ever documented robot-assisted repair of a perineal hernia. • In-depth description of operative method. • Video demonstrating the ease of mesh placement and suturing in the deep pelvis. Introduction Perineal hernia is a protrusion of the pelvic floor containing intra-abdominal viscera. The occurrence of postoperative perineal hernia after abdominoperineal resection (APR) is rare, but reports have indicated a recent increase in occurrence following surgical treatment for rectal cancer. This has been attributed to a shift towards extralevator abdominoperineal resection, together with more frequent and long-term use of neoadjuvant therapy. Presentation of case Here, we report the case of a patient who underwent APR for cancer. Twenty months postoperative, a perineal hernia was detected. The patient was electively scheduled for surgery. Robot-assisted laparoscopy was performed using the da Vinci Surgical System. The perineal hernia was repaired by primary closure with the placement of Symbotex Composite mesh as reinforcement for the pelvic floor. The surgery was performed without any adverse events, and the patient was discharged the day after surgery. Clinical follow-up proceeded at the designated time intervals without difficulties. Discussion Recurrence rates of perineal hernia remain high, and surgeons face numerous challenges related to poor view, suturing and mesh placement in the deep pelvis. Numerous approaches have been described, but there is still no consensus as to the optimal repair technique for perineal hernia. Conclusion Symptomatic perineal hernias can feasibly be repaired with robot-assisted laparoscopy. Furthermore, suturing and mesh placement require less effort with the robot approach when compared to the open and laparoscopic approaches. These promising findings are demonstrated in the included video. |
| Databáze: | OpenAIRE |
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