Evaluation of the effectiveness of preventive techniques for postoperative inguinal hernia following robot-assisted radical prostatectomy

Introduction: Inguinal hernias following robot-assisted radical prostatectomy (RARP) for localized prostate cancer develop occasionally. The purpose of this study was to review our surgical technique for preventing postoperative inguinal hernia (PIH) and to evaluate its effectiveness. Methods A total of 596 patients who underwent RARP at our institution were included. Patient background factors, perioperative factors, surgical outcomes, and the incidence of postoperative inguinal hernia were reviewed. The patients were divided into two groups: those who underwent hernia prevention procedures and those who did not. A retrospective analysis was conducted to evaluate the risk factors for postoperative inguinal hernia. Results Of a total of 596 patients, 170 (29%) did not undergo hernia prevention procedures, and 426 (71%) did. The median age of all patients was 69 years, and Body Mass Index (BMI) was 23.7 kg/m ² . In the group that did not undergo hernia prevention procedures, 13 cases (7.6%) of PIH occurred, whereas in the group that underwent hernia prevention procedures, 10 cases (2.3%) occurred. The median time to PIH was 9 (3–36) months. PIH incidence was significantly lower in the hernia prevention group (P = 0.004). On multivariate analysis, the hernia prevention procedure was identified as an independent factor associated with a lower risk of PIH (hazard ratio (HR): 0.384, 95% confidence interval (CI): 0.161–0.916, P = 0.03). Conclusions The incidence of PIH was significantly lower when hernia prevention techniques were performed. We believe that our surgical technique might reduce the risk of developing this complication.