{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:06:14Z","timestamp":1789164374414,"version":"build-2803163510"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["J. Abdom. Wall Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perineal hernias, protrusions through the pelvic diaphragm, are a rare complication post-abdominoperineal resection. The shift to extralevator APR techniques could be linked to a potential increase in these hernias. This case series evaluates the surgical management of perineal hernias, focusing on the evolving role of robotic surgery. Given the limited existing research on robotic repairs in this context, it highlights its potential as an innovative approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Presentation of Case<\/jats:title><jats:p>In a case series, we report three patients who underwent robotic abdominoperineal resection (APR) for rectal and anal canal carcinoma after neoadjuvant chemoradiation. The 65-year-old female developed a perineal hernia 7\u00a0months post-operatively, the 67-year-old male after 4\u00a0years, and the 63-year-old female presented with a recurrent perineal hernia post-APR with gracilis flap reconstruction. All patients underwent successful robotic hernia repairs with mesh placement and demonstrated symptomatic improvement post-operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Perineal hernia management lacks a standardized protocol, with methods ranging from open to laparoscopic techniques. A review of recent literature suggests increasing favorability towards laparoscopic and robotic approaches due to their less invasive nature. Our cases demonstrate the advantages of robotic surgery\u2019s precision and improved visualization, supporting its use in perineal hernia repair, although more research is needed to confirm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Robotic-assisted surgery for perineal hernia repair post-APR shows promise, enhancing the benefits of laparoscopic methods. This series underlines the potential of this approach, though further investigation in larger studies is essential to establish its advantages.<\/jats:p><\/jats:sec>","DOI":"10.3389\/jaws.2024.13481","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T04:11:02Z","timestamp":1732853462000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Robotic Repair of a Perineal Hernia Following Abdominoperineal Resection"],"prefix":"10.3389","volume":"3","author":[{"given":"Madison","family":"Brune","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Hotop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Silliman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Bartow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"B1","first-page":"514","article-title":"Perineal Hernia","author":"Moshcowitz","year":"1916","journal-title":"Surg Gynecol Obstet"},{"key":"B2","first-page":"A5383","article-title":"Low Incidence of Perineal Hernia Repair After Abdominoperineal Resection for Rectal Cancer","volume":"64","author":"Levic","year":"2017","journal-title":"Danish Med J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/j.1463-1318.2012.02970.x","article-title":"Perineal Hernia Repair After Abdominoperineal Resection: A Pooled Analysis","volume":"14","author":"Mjoli","year":"2012","journal-title":"Colorectal Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1053\/j.scrs.2009.06.007","article-title":"Post-Operative Perineal Hernia","volume":"20","author":"Wang","year":"2009","journal-title":"Semin Colon Rectal Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1007\/10029-015-1449-3","article-title":"Laparoscopic Repair of Perineal Hernia After Abdominoperineal Excision","volume":"20","author":"Haan","year":"2015","journal-title":"Hernia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.ijscr.2018.12.009","article-title":"Robot-Assisted Laparoscopic Repair of Perineal Hernia After Abdominoperineal Resection: A Case Report and Review of the Literature","volume":"55","author":"Rajabaleyan","year":"2019","journal-title":"Int J Surg case Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s00384-020-03506-0","article-title":"A New Method of Robot-Assisted Laparoscopic Repair of Perineal Hernia After Abdominoperineal Resection: A Case Report","volume":"35","author":"Li","year":"2020","journal-title":"Int J Colorectal Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s10151-017-16348","article-title":"Perineal Hernia Repair After Abdominoperineal Excision or Extralevator Abdominoperineal Excision: A Systematic Review of the Literature","volume":"21","author":"Balla","year":"2017","journal-title":"Coloproctol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1002\/bjs.6916","article-title":"Multicentre Experience With Extralevator Abdominoperineal Excision for Low Rectal Cancer","volume":"97","author":"West","year":"2010","journal-title":"Br J Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1111\/codi.12843","article-title":"Perineal Hernia Formation Following Extralevator Abdominoperineal Excision","volume":"17","author":"Sayers","year":"2015","journal-title":"Colorectal Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"61","DOI":"10.5604\/01.3001.0015.7677","article-title":"Perineal Hernia After Abdominoperineal Resection - 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