Osvaldo Zumba, MD1, Joanne E Glanville, MD2, George Mazpule, MD1, Stephen G Pereira, MD, FACS1, Adam Rosenstock, MD, FACS1. 1Hackensack University Medical Center, 2Surgical Associates of Richmond
The use of robotics to perform minimally invasive surgery has emerged as a viable option for most general surgery procedures. The robotic platform offers better visualization and allows for a minimally invasive approach for more complex procedures that require advanced surgical skills. Though the robot platform offers such a great advantage compared to laparoscopy, its use for emergent procedures has been limited. Specifically in patients with perforations of the GI tract, a laparoscopic or open approach is usually used for repair. Here we present the case of a 43-year-old male who, secondary to chronic NSAID use, had one week of epigastric abdominal pain. After workup, CT imaging of the abdomen reveal gross perforation of the proximal duodenum with extravasation of oral contrast. Though the patient likely had this perforation several days prior and appeared to be septic, we proceeded with a robotic approach for repair. This video shows our approach to the robotic omental/Graham patch in a patient with delayed presentation. Four days after his procedure, the patient’s upper GI imaging was negative for leak and he was able to tolerate a regular diet. Significantly, the patient’s abdominal pain resolved almost immediately after surgery and required minimal analgesics during his hospital stay. The robotic surgical approach offers the potential for expanded use in all general surgical procedures, including those that are traditionally managed open, such as a perforated duodenum in this case.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95295
Program Number: V356
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop