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Updated: Jul 14, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Persistent bilateral pneumothorax after robotic-assisted inguinal hernia repair: possible relevance to recent
Seiji Ishikawa1, Kaori Shirakawa2, Yui Kuroda3
1Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. seiji.ishikawa.juntendo@gmail.com.
Background:
Postoperative pneumothorax is a well-known but relatively rare complication after laparoscopic surgery. There has been no report describing pneumothorax that persisted for a week or more after laparoscopic surgery. Herein, we report a case of bilateral pneumothorax after laparoscopic surgery, which appears to have occurred by a different mechanism than previously described.
Case Presentation:
A 65-year-old male, with a past history of esophagectomy and retrosternal gastric tube reconstruction 4 months earlier, underwent a robotic-assisted inguinal hernia repair. Postoperative chest x-rays revealed the development of bilateral pneumothorax, which became worse on postoperative day (POD) 1 and took more than 9 days to resolve spontaneously. We assumed that intra-abdominal gas replaced by the air after pneumoperitoneum might have migrated into thoracic cavities through an opened esophageal hiatus or along the retrosternal route.
Conclusions:
Laparoscopic surgery after radical esophagectomy may be associated with an increased risk of postoperative pneumothorax.
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