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Massive subcutaneous emphysema in robotic sacrocolpopexy.

Authors
  • Celik, Hatice
  • Cremins, Angela
  • Jones, Keisha A
  • Harmanli, Oz
Type
Published Article
Journal
JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Publication Date
Jan 01, 2013
Volume
17
Issue
2
Pages
245–248
Identifiers
DOI: 10.4293/108680813X13654754535151
PMID: 23925018
Source
Medline
License
Unknown

Abstract

The advent of robotic surgery has increased the popularity of laparoscopic sacrocolpopexy. Carbon dioxide insufflation, an essential component of laparoscopy, may rarely cause massive subcutaneous emphysema, which may be coincident with life-threatening situations such as hypercarbia, pneumothorax, and pneumomediastinum. Although the literature contains several reports of massive subcutaneous emphysema after a variety of laparoscopic procedures, we were not able to identify any report of this complication associated with laparoscopic or robotic sacrocolpopexy. Massive subcutaneous emphysema occurred in 3 women after robotic sacrocolpopexy in our practice. The patients had remarkable but reversible physical deformities lasting up to 1 week. A valveless endoscopic dynamic pressure system was used in all 3 of our cases. Our objective is to define the risk of massive subcutaneous emphysema during robotic sacrocolpopexy in light of these cases and discuss probable predisposing factors including the use of valveless endoscopic dynamic pressure trocars.

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