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Iatrogenic Intrathoracic Insufflation During Robot-Assisted Laparoscopic Paraoesophageal Hernia Repair with Toupet Fundoplication

Year: 2025

Type: article

Abstract: Minimally invasive surgery, including robotic-assisted laparoscopic procedures, has largely replaced open surgery due to its numerous benefits. However, this approach introduces unique complications such as intraoperative pneumothorax, particularly during upper gastrointestinal (GI) surgeries near the diaphragmatic hiatus. We report the case of a 50-year-old male patient undergoing robotic paraesophageal hernia repair with Toupet fundoplication who developed a tension pneumothorax intraoperatively. Clinical signs included rising peak airway pressures, progressive hypoxemia, and absent right-sided breath sounds. Rapid recognition and immediate chest tube decompression restored ventilation and prevented hemodynamic collapse. The patient recovered without major complications and was discharged on postoperative day two. Overall, intrathoracic insufflation with tension physiology during laparoscopic upper GI surgery is a rare and potentially life-threatening complication. This case highlights the importance of anesthetic vigilance, prompt recognition of ventilatory changes, and swift multidisciplinary intervention to ensure optimal outcomes.

Source: Cureus

DOI: 10.7759/cureus.83604

Authors: Rahul Venna, Tomohiro Yamamoto, Satoshi Yamamoto

Institutions: The University of Texas Medical Branch at Galveston, Gunma University

Language: English

Topic: Pneumothorax, Barotrauma, Emphysema

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410113075