Robotic-assisted laparoscopic primary repair of acute iatrogenic colonic perforation: case report

Int J Med Robot. 2012 Sep;8(3):375-8. doi: 10.1002/rcs.1447. Epub 2012 Jun 27.

Abstract

Background: Colonic perforation during colonoscopy is a rare complication and is usually considered a surgical emergency. Traditionally, such perforations have required laparotomy with repair or resection. Minimally invasive approaches have recently been successfully implemented. We describe our initial experience with a robotic-assisted laparoscopic technique for primary colorrhaphy following colonoscopic perforation.

Methods: An 84 year-old female presented with an acute sigmoid perforation identified during colonoscopy. Laparoscopic exploration revealed a full-thickness tear into the sigmoid mesentery, which was primarily repaired using robotic-assisted technique.

Results: The procedure was successfully completed in 135 min with an estimated blood loss of 25 ml. There were no intraoperative complications or need for open conversion. The patient was discharged after 4 days without further hospitalization or secondary surgical intervention.

Conclusion: In the presented case, robotic primary colorrhaphy was demonstrated to be a safe and feasible alternative for the management of acute colonoscopic perforation and may warrant consideration in the emergency setting.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colonic Diseases / etiology
  • Colonic Diseases / surgery*
  • Colonoscopy / adverse effects
  • Digestive System Surgical Procedures / instrumentation
  • Digestive System Surgical Procedures / methods*
  • Emergencies
  • Female
  • Humans
  • Iatrogenic Disease*
  • Intestinal Perforation / etiology
  • Intestinal Perforation / surgery*
  • Laparoscopy / instrumentation
  • Laparoscopy / methods
  • Robotics / instrumentation
  • Robotics / methods*
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*