Strangulated ileus due to anterior enterocele following robot-assisted radical cystectomy: A case report of rare complication managed with minimally invasive surgery.

INTRODUCTION

The incidence of anterior enterocele following robotic radical cystectomy is reported to be approximately 3 %, making it a rare complication. We experienced a case in which a patient developed an anterior enterocele and strangulated ileus through the urethral excision site, for which intracorporeal anastomosis proved to be an effective treatment under a specific and limited clinical situation.

PRESENTATION OF CASE

A 72-year-old woman underwent a robot- assisted radical cystectomy for bladder cancer. At nine months post-operation, she presented with small bowel evisceration resulting from dehiscence of an anterior enterocele accompanied by strangulated ileus. Laparoscopic small bowel resection with intracorporeal anastomosis (IA) was performed. Oral intake of food was resumed on post-operative day 3, and the patient was discharged without complications on post-operative day 10.

DISCUSSION

In cases of strangulated ileus with dilated bowel loops, minimally invasive surgery incorporating IA can be safely performed by temporarily utilizing an intestinal bulldog clamp for the bowel, employing indocyanine green fluorescence imaging, and selecting an appropriate anastomotic technique. If an adequate surgical environment is maintained, IA may be a viable option for the treatment of strangulated ileus.

CONCLUSION

IA may be a viable option for treating strangulated ileus in a limited situation.