Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity
Introduction. Unique challenges exist with conventional laparoscopic operations in patients with super obesity (BMI>50). Limited literature is available regarding use of the robotic platform to treat patients with super obesity or acute care surgery patients. This case describes an interval robot...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2021/9992622 |
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| _version_ | 1832556453857067008 |
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| author | Diane Bronikowski Dominic Lombardo Connie DeLa’O Nova Szoka |
| author_facet | Diane Bronikowski Dominic Lombardo Connie DeLa’O Nova Szoka |
| author_sort | Diane Bronikowski |
| collection | DOAJ |
| description | Introduction. Unique challenges exist with conventional laparoscopic operations in patients with super obesity (BMI>50). Limited literature is available regarding use of the robotic platform to treat patients with super obesity or acute care surgery patients. This case describes an interval robotic subtotal cholecystectomy in an elderly patient with super obesity and multiple comorbidities. Case Description. A 74-year-old male with a BMI of 59.9 developed acute cholecystitis. He was deemed excessively high risk for operative intervention due to concurrent comorbid conditions and underwent percutaneous cholecystostomy. After a few months, a cholangiogram demonstrated persistent cystic duct occlusion. The patient expressed interest in tube removal and elective interval cholecystectomy. After preoperative risk stratification and optimization, he underwent a robotic subtotal cholecystectomy with near infrared fluorescence cholangiography. The patient was discharged on postoperative day one and recovered without complications. Discussion. Obesity is a risk factor for acute cholecystitis, which is most commonly treated with conventional laparoscopy (CL). CL is technically restraining and difficult to perform in patients with super obesity. The body habitus of patients with super obesity can impair proper instrumentation and increase perioperative morbidity. In this case, robotic assisted cholecystectomy console improved surgeon ergonomics and provided support for proper instrumentation. Robotic, minimally invasive cholecystectomy approaches may reduce perioperative morbidity in patients with super obesity. Further studies are necessary to address the role of robotic surgery in acute care surgery patients with super obesity. |
| format | Article |
| id | doaj-art-1a05984e08754d9d9a34890414ec3fdd |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-1a05984e08754d9d9a34890414ec3fdd2025-02-03T05:45:20ZengWileyCase Reports in Surgery2090-69002090-69192021-01-01202110.1155/2021/99926229992622Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super ObesityDiane Bronikowski0Dominic Lombardo1Connie DeLa’O2Nova Szoka3West Virginia University, Department of Surgery, Morgantown, WV 26505, USAWest Virginia University, Department of Surgery, Morgantown, WV 26505, USAWest Virginia University, Department of Surgery, Morgantown, WV 26505, USAWest Virginia University, Department of Surgery, Morgantown, WV 26505, USAIntroduction. Unique challenges exist with conventional laparoscopic operations in patients with super obesity (BMI>50). Limited literature is available regarding use of the robotic platform to treat patients with super obesity or acute care surgery patients. This case describes an interval robotic subtotal cholecystectomy in an elderly patient with super obesity and multiple comorbidities. Case Description. A 74-year-old male with a BMI of 59.9 developed acute cholecystitis. He was deemed excessively high risk for operative intervention due to concurrent comorbid conditions and underwent percutaneous cholecystostomy. After a few months, a cholangiogram demonstrated persistent cystic duct occlusion. The patient expressed interest in tube removal and elective interval cholecystectomy. After preoperative risk stratification and optimization, he underwent a robotic subtotal cholecystectomy with near infrared fluorescence cholangiography. The patient was discharged on postoperative day one and recovered without complications. Discussion. Obesity is a risk factor for acute cholecystitis, which is most commonly treated with conventional laparoscopy (CL). CL is technically restraining and difficult to perform in patients with super obesity. The body habitus of patients with super obesity can impair proper instrumentation and increase perioperative morbidity. In this case, robotic assisted cholecystectomy console improved surgeon ergonomics and provided support for proper instrumentation. Robotic, minimally invasive cholecystectomy approaches may reduce perioperative morbidity in patients with super obesity. Further studies are necessary to address the role of robotic surgery in acute care surgery patients with super obesity.http://dx.doi.org/10.1155/2021/9992622 |
| spellingShingle | Diane Bronikowski Dominic Lombardo Connie DeLa’O Nova Szoka Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity Case Reports in Surgery |
| title | Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity |
| title_full | Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity |
| title_fullStr | Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity |
| title_full_unstemmed | Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity |
| title_short | Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity |
| title_sort | robotic subtotal cholecystectomy in a geriatric acute care surgery patient with super obesity |
| url | http://dx.doi.org/10.1155/2021/9992622 |
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