Incarcerated ventral wall hernia after robotic urogynecologi
• Complex robotic urogynecology surgery may increase the risk of trocar site hernia.

• Pelvic organ prolapse is an important risk factor to consider for trocar site hernia.

• Surgeons should inspect robotic port sites for extensions after complex dissection.

• Careful closure of peritoneal and/or fascial extensions may be warranted.

Trocar site hernia is a rare complication of minimally invasive surgery, with incidence estimates varying widely. Studies have demonstrated rates of up to 1.2% in patients undergoing gynecologic surgery. Yet, little is known about hernia risk in the urogynecologic patient population who undergo robotic reconstructive surgery. Risk factors for the development of trocar site hernia include both incisional risk factors (trocar placement location, trocar diameter, intraoperative trocar manipulation) and patient risk factors (obesity, pelvic organ prolapse or other hernia). A large incarcerated small bowel hernia at a trocar site following robotic urogynecologic surgery and the resulting interventions, including repeat surgery, to reduce the hernia in a 66-year-old woman. Such a case should prompt urogynecologic surgeons to check port sites after extensive dissections to assess if large peritoneal or fascial defects need additional closure.