Diffuse Subcutaneous Emphysema, Pneumomediastinum, and Pneumothorax following Robotic Assisted Laparoscopic Hysterectomy

Abstract

Robotic assisted laparoscopic surgery is becoming more widely available, but despite its multiple benefits, it is not without risk. This case is of a 62-year-old female who presented to the emergency department for dyspnea two days after robotic assisted laparoscopic hysterectomy. Physical exam revealed diffuse facial, neck, upper extremity, torso, and lower extremity crepitus, which was diagnosed as diffuse subcutaneous air on computed tomography (CT). Imaging also revealed right apical pneumothorax and pneumomediastinum. The patient progressively improved over one month, with resolution of symptoms.

Subcutaneous Emphysema during Robot-Assisted Radical Cystectomy

“…Although open radical cystectomy is described as a gold standard treatment method of MIBC, minimally invasive methods have gained in popularity in recent years. Because of similar oncological outcomes and less invasive approach and less blood loss and lower perioperative and postoperative complications, RLC and RALC have been the reason for surgical preference (6). In our case RALC was used for the surgical procedure.…”

“…In the literature, there are some reports addressing massive SE in robotic gynecological surgery. However, we did not encounter a report showing its occurrence during RALC (5,6). Thus, we report the case of a 53-year-old male patient who underwent RALC with 15 mmHg intraabdominal CO 2 pressure and had SE perioperatively.…”

Free air after laparoscopic hysterectomy; from sigmoid perforation to upper airway compromise: a case report

“…• gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year evaluation, the first of the patient symptoms would guide us towards laparoscopic surgery and its relatively easy treated complications. It has been stated that postlaparoscopic pneumoperitoneum resolves within three days in 81% of the patients [2,3]; It should be underlined though that normal excretion of CO 2 is 100-200 mL/minutes and is increased by 14-48 mL/minutes when CO 2 is administered intraperitoneally. CO 2 has a high solubility and thus complications like capnothorax, subcutaneous emphysema, pneumothorax and pneumomediastinum due to laparoscopy are expected to occur within the 24 hours after laparoscopic surgery.…”