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Recurrent sigmoid volvulus after robotic-assisted laparoscopic prostatectomy
Kunind Oberoi1, Kapil Sethi1,2
1Department of Surgery, The University of Melbourne, Parkville, VIC, Australia.
Urology Case Reports
|March 17, 2025
Summary
A rare case of sigmoid volvulus occurred after robotic-assisted laparoscopic prostatectomy (RALP). This complication, potentially linked to RALP procedures, highlights the need for clinical awareness in at-risk patients.
Area of Science:
- Urology
- Gastroenterology
- Surgical Complications
Background:
- Robotic-assisted laparoscopic prostatectomy (RALP) is a common procedure for prostate cancer.
- Postoperative complications typically involve urinary or sexual dysfunction.
- Gastrointestinal complications are less common but can be severe.
Observation:
- A 73-year-old male developed severe constipation, obstipation, and abdominal distension 19 days post-RALP.
- Imaging revealed sigmoid volvulus, initially managed with endoscopic detorsion.
- The patient experienced recurrence two months later, necessitating a colectomy.
Findings:
- Sigmoid volvulus is a rare but serious complication following RALP.
- Potential contributing factors include patient positioning, pneumoperitoneum, and mesenteric mobilization during surgery.
- This complication has not been previously reported in the literature after RALP.
Implications:
- Clinicians should maintain a high index of suspicion for sigmoid volvulus in patients presenting with gastrointestinal symptoms post-RALP.
- Elderly patients with predisposing anatomical factors may be at increased risk.
- Consideration of intraoperative techniques, such as lateral repair of the sigmoid colon during dissection, may be warranted to prevent recurrence.
