Laparoscopic Robotic Radical Hysterectomy in an Adult with Congenital Heart Disease: A Case Report and Review of the Literature
DOI:
https://doi.org/10.12970/2311-052X.2016.04.02.1Keywords:
Congenital heart defect, adult congenital heart disease, laparoscopy, gynecologic oncology, radical robotic hysterectomy.Abstract
Purpose: Non-cardiac surgeries in adults with congenital heart disease are increasing due to improved survival of children with congenital heart disease. There has also been an increase in laparoscopic procedures due to benefits including decreased length of stay and improved quality of life. There have been concerns regarding laparoscopic surgery in patients with congenital heart disease especially with pneumoperitoneum and positioning related to hemodynamic effects. We present a case of laparoscopic surgery in an adult with congenital heart disease who underwent robotic radical hysterectomy and provide a review of the literature.
Methods/Results: The case of a 39 year old female with palliated congenital heart disease who underwent laparoscopic robotic radical hysterectomy for cervical cancer was summarized. A review of the literature was performed. Ten surgeries in 9 adult patients were reported with good outcomes. Insufflation pressures were reported in 8 of 10 surgeries and kept at or below 15 mmHg.
Conclusions: When performed in centers with experience in CHD, non-cardiac laparoscopic surgery has been shown to be safe and effective. CO2 abdominal insufflation pressures should be reduced as much as possible without compromising visualization, in order to decrease potential negative effects on hemodynamics.
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