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Massive subcutaneous emphysema in robotic sacrocolpopexy
Hatice Celik1, Angela Cremins, Keisha A Jones
1Department of Obstetrics and Gynecology, Tufts University School of Medicine, Springfield, MA, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 9, 2013
Summary
Robotic sacrocolpopexy can rarely cause massive subcutaneous emphysema, a reversible condition. This complication may be linked to the use of valveless endoscopic dynamic pressure systems during the procedure.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Surgical Complications
Background:
- Robotic surgery is increasingly used for laparoscopic sacrocolpopexy.
- Carbon dioxide insufflation is standard in laparoscopy but can lead to complications.
- Massive subcutaneous emphysema is a rare but serious complication.
Observation:
- Three cases of massive subcutaneous emphysema occurred post-robotic sacrocolpopexy.
- Patients experienced significant, temporary physical deformities.
- A valveless endoscopic dynamic pressure system was utilized in all cases.
Findings:
- This study identifies massive subcutaneous emphysema as a potential complication of robotic sacrocolpopexy.
- No prior reports linked this specific complication to robotic or laparoscopic sacrocolpopexy.
- The use of valveless endoscopic dynamic pressure trocars is a potential contributing factor.
Implications:
- Highlights a previously unreported risk in robotic sacrocolpopexy.
- Suggests careful consideration of insufflation techniques and equipment.
- Informs surgeons about potential predisposing factors and patient monitoring.
