Iatrogenic bowel injury (early vs delayed)

Rectal Perforation During Pelvic Surgery

“…Most of them are derived from the experience with RP. Prior pelvic surgery (rectal or prostate surgery) or radiation treatment represents factors altering perirectal planes with possible adhesion [1] , [26] ; similarly, in gynecologic robotic surgery, a prior porcine dermis graft may induce dense adhesions in the rectovaginal space [27] . Locally advanced tumors, in particular high-risk or locally advanced prostate cancer (PCa) [9] , [25] .…”

“…In the more recent robotic RP series, the occurrence of RIs in the salvage setting is comparable with that of the primary settings; however, it should be remarked that such experience is derived mainly from highly experienced surgeons and high-volume centers [33] , [34] . Patient characteristics, that is, obesity and older age, were identified as possible risk factors for iatrogenic bowel injury, but evidence in literature is scarce [1] . A very recent transrectal prostate biopsy may alter the plane between the prostate and the rectum.…”

“…The small as well as large intestine is in close proximity to numerous intra-abdominal, retroperitoneal, and pelvic organs; they occupy sizable portions of the abdominal and pelvic cavities, have variable lengths, and are prone to dynamic motion. Urologic, gynecologic, and general surgeries are the most common causes of iatrogenic bowel injury [1] . In general, bowel injury may occur during organ dissection, visceral manipulation, or abdominal wall entering/closure.…”

“…Rectal injuries (RIs) during pelvic surgery are rare but severe complications. The rate of RIs is generally lower than the rate of injuries of other portions of the bowel; the majority of studies describes that the rate of small bowel lesions widely exceeds colorectal ones [1] , [2] .…”

Perforated Colon Cancer Associated With Post-operative Recurrent Bowel Perforations

“…Her history of multiple invasive abdominal procedures significantly increased her risk for bowel perforation. Extensive adhesion formation from numerous abdominal surgeries alters abdominal anatomy and modifies natural planes [ 12 ]. The fusion of multiple intra-abdominal structures makes isolation of portions of the intestines challenging.…”