Rare small bowel obstruction: Parastomal hernia of cutaneous ureterostomy after robot-assisted radical cystectomy. Case report

Abstract

Robot-assisted radical cystectomy with or without intracorporeal urinary diversion has recently been explored as a viable surgical option for multiple, recurrent and muscle invasive bladder cancer. In this report, an 84-year-old female diagnosed as having invasive bladder cancer underwent robot-assisted radical cystectomy with intracorporeal cutaneous ureterostomy: in the third postoperative day, computed tomography of the abdomen was suggestive of incarcerated hernia through the abdominal wall defect created by the left ureterostomy. Subsequently, the parastomal hernia was repaired laparoscopically. To the best of our knowledge, this is the first report of a symptomatic parastomal hernia related to the cutaneous ureterostomy.

Keywords: Bladder cancer; MIBC, (muscle invasive bladder cancer); PSH, (parastomal hernia); Parastomal hernia; RARC, (robot-assisted radical cystectomy); Radical cystectomy; Robot-assisted radical cystectomy.

Fig. 1

Computed tomography of the abdomen and pelvis demonstrating the presence of small bowel loops herniated through the left abdominal wall (red arrow), with dilated proximal small bowel segments (red arrowhead), suggestive of incarcerated parastomal hernia. The white arrow indicates the left ureteral stent.

Fig. 2

Laparoscopic surgery confirming the presence of an incarcerated hernia through the abdominal wall defect created by the left ureterostomy.