Delayed subcutaneous emphysema in an acute weight loss female following robotic surgery

Abstract

Robotic-assisted laparoscopy with the use of carbon dioxide (CO2) for insufflation is rapidly adopted procedure for gynecological surgery. Insufflation of the abdomen with CO2can potentially cause complications such as hypercarbia, subcutaneous emphysema (SE), pneumothorax, and pneumomediastinum. The incidence of SE ranges from 0.43% to 77%. Numerous potential mechanisms were proposed for the development of these complications. Several authors speculated that the surgical time, surgical ports, age, and peritoneal insufflation pressures are related to the development of these complications. These potentially lethal complications must be diagnosed and managed promptly. We experienced a case who developed delayed massive SE extended to neck and face after robotic ovarian cystectomy, it perhaps due to weaker tissues bonding fascial planes because she was acute weight loss within 1 month.

Keywords

• Laparoscopy
• subcutaneous emphysema
• acute weight loss