Robotic Laparoscopic Management of Acute Iatrogenic Colonic Perforation Following Colonoscopy: A Case Report

Del Pino M.; Hidalgo-Avendaño D. · World Journal of Laparoscopic Surgery (2024) · DOI: 10.5005/jp-journals-10033-1622

Resumen

Background: Complications during colonoscopy such as perforation or bleeding may occur. Colonic perforation must be detected early in order to manage and reduce morbidity and mortality. Conservative, endoscopic, or surgical (laparoscopy or laparotomy) management techniques are available. The objective of this case report is to describe the management of a patient with post-colonoscopy polypectomy colonic perforation using a robotic platform approach. Case presentation: A 59-year-old male presented with a medical history significant for hypertension and hyperlipidemia, and he had several polyps removed with colonoscopy the day before admission. He started to have some left-sided abdominal pain which worsened and then moved to the right side. The primary diagnoses, interventions, and outcomes: CT scan was performed and revealed a small volume pneumoperitoneum, consistent with hollow viscus perforation and peritoneal signs on physical exam. He was taken to the OR for emergency robotic diagnostic laparoscopy, and proximal transverse colon repair with peritoneal lavage was successfully completed. There were no intraoperative complications or need for open conversion. The patient was discharged after 2 days and he did not suffer postoperative complications and did not need readmission. Conclusion: The robotic platform offers advantages that overcome the limitations of the laparoscopic approach including visualization, stability, dexterity, and precision. We believe that these advantages are maximized in the acute surgery setting. This case report proves that in experienced hands, the robotic platform is safe and effective for acute complex surgery cases. Further studies are recommended to determine the specific benefits of robotic laparoscopy in colonic emergency procedures. © The Author(s). 2024.

Instituciones: Universidad Peruana Cayetano Heredia