Celik Hatice, Cremins Angela, Jones Keisha A, Harmanli Oz
Department of Obstetrics and Gynecology, Tufts University School of Medicine, Springfield, MA, USA.
JSLS. 2013 Apr-Jun;17(2):245-8. doi: 10.4293/108680813X13654754535151.
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.
机器人手术的出现提高了腹腔镜骶骨阴道固定术的普及程度。二氧化碳气腹是腹腔镜检查的一个重要组成部分，可能很少会导致大量皮下气肿，这可能与高碳酸血症、气胸和纵隔气肿等危及生命的情况同时发生。虽然文献中有几篇关于各种腹腔镜手术后大量皮下气肿的报道，但我们未能找到任何与腹腔镜或机器人骶骨阴道固定术相关的这种并发症的报道。在我们的实践中，3名女性在机器人骶骨阴道固定术后发生了大量皮下气肿。患者出现了持续长达1周的明显但可逆的身体畸形。我们所有3例病例均使用了无瓣膜内镜动态压力系统。我们的目的是根据这些病例确定机器人骶骨阴道固定术中发生大量皮下气肿的风险，并讨论可能的诱发因素，包括使用无瓣膜内镜动态压力套管针。
