Robotic-assisted laparoscopic primary repair of acute iatrogenic colonic perforation: case report.
BACKGROUND
Colonic perforation during colonoscopy is a rare complication and is usually considered a surgical emergency. Traditionally, such perforations have required laparotomy with repair or resection. Minimally invasive approaches have recently been successfully implemented. We describe our initial experience with a robotic-assisted laparoscopic technique for primary colorrhaphy following colonoscopic perforation.


METHODS
An 84 year-old female presented with an acute sigmoid perforation identified during colonoscopy. Laparoscopic exploration revealed a full-thickness tear into the sigmoid mesentery, which was primarily repaired using robotic-assisted technique.


RESULTS
The procedure was successfully completed in 135 min with an estimated blood loss of 25 ml. There were no intraoperative complications or need for open conversion. The patient was discharged after 4 days without further hospitalization or secondary surgical intervention.


CONCLUSIONS
In the presented case, robotic primary colorrhaphy was demonstrated to be a safe and feasible alternative for the management of acute colonoscopic perforation and may warrant consideration in the emergency setting.
Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, University of Texas Medical School, Houston, TX, USA.
Rodrigo
R
Pedraza
Madhu
M
Ragupathi
Tara
T
Martinez
Eric M
EM
Haas
D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D004630:Emergencies; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*