Trocar site hernia resulting in intestinal necrosis 48 hours after robot‐assisted radical prostatectomy

Abstract

Introduction Trocar site hernia is a potentially serious sequela of laparoscopic procedures that may lead to bowel incarceration and strangulation. We report a case of trocar site hernia secondary to robot‐assisted radical prostatectomy. Case presentation A 71‐year‐old Japanese man underwent robot‐assisted radical prostatectomy without any intraoperative events; however, a brief dislodgement of a 12‐mm AIRSEAL® trocar occurred. Forty‐eight hours after the procedure, the patient exhibited coffee ground vomitus. Computed tomography revealed an intestinal prolapse at the 12‐mm AIRSEAL® trocar site. He was diagnosed with a strangulated bowel due to trocar site hernia. Following an emergency exploration, 25 cm of gangrenous intestine was resected, and a functional end‐to‐end anastomosis was performed. Conclusion In this case, brief dislodgement of the AIRSEAL® trocar may have caused severe subcutaneous emphysema and intestinal sucking. In such situations, certain closure of both, the peritoneum and the fascia, is necessary.

Keywords

• intestinal necrosis
• prostate cancer
• robot‐assisted radical prostatectomy
• surgical complication
• trocar site hernia