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Cerebral oedema following robotic surgery: a rare complication

  • Case Report
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

We present an unusual complication following robotic assisted radical hysterectomy.

Case report

A 51-year-old female with stage 1B1 cervical cancer underwent a robotic assisted radical hysterectomy. The procedure was prolonged with difficulties dissecting the left parametrium and vaginal fornix with persistent bleeding from the left vaginal vault. Post-operatively the patient was electively sedated and ventilated. Extubation was difficult due to patient agitation but achieved on day 2. Agitation persisted and a head CT scan was performed and a diagnosis of cerebral oedema was made.

Discussion

Factors contributing to this case include prolonged operating time, prolonged Trendelenburg position with high pressures of CO2 pneumoperitoneum and excessive blood loss. These factors may contribute to poor cerebral venous outflow, increasing intracranial pressure leading to increased risk of cerebral oedema.

Conclusion

The mechanics of robotic assistance may be used to reduce these risks by significantly reducing intra-abdominal pressure improving venous return.

Summary

The use of robotics in surgery has been increasing over the last 10 years, and the benefits have been well documented. We present an unusual complication following robotic assisted radical hysterectomy performed for cervical cancer.

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Conflict of interest

All the authors confirm and declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gynaecological Oncology, Royal Surrey County Hospital NHS Foundation Trust, Egerton Rd, Guildford, GU2 7XX, UK

    Chloe Barr, Thumuluru Kavitha Madhuri, Simon Butler-Manuel & Anil Tailor

  2. Department of Anaesthetics and Intensive Care, Royal Surrey County Hospital NHS Foundation Trust, Egerton Rd, Guildford, GU2 7XX, UK

    Pradeep Prabhu

Authors
  1. Chloe Barr
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  2. Thumuluru Kavitha Madhuri
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  3. Pradeep Prabhu
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  4. Simon Butler-Manuel
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  5. Anil Tailor
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Corresponding author

Correspondence to Thumuluru Kavitha Madhuri.

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Barr, C., Madhuri, T.K., Prabhu, P. et al. Cerebral oedema following robotic surgery: a rare complication. Arch Gynecol Obstet 290, 1041–1044 (2014). https://doi.org/10.1007/s00404-014-3355-9

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  • DOI: https://doi.org/10.1007/s00404-014-3355-9

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