Recognition and Management of Subcutaneous Emphysema as a Complication of Robotic-Assisted Laparoscopic Surgery: A Case Report.

Abstract

This case report discusses an unlikely occurrence of massive subcutaneous emphysema in an elective robotic-assisted laparoscopic total hysterectomy in a 45-year-old, ASA class 1 woman. The patient's perioperative course was otherwise uncomplicated, with the subcutaneous emphysema developing at surgical closure. The patient presented with substantial crepitus spanning from her face to her lower extremities and hypercarbia with end-tidal carbon dioxide readings persistent between 60 and 70 mm Hg. This case did not result in clinically significant airway obstruction because of provider vigilance. However, undiagnosed subcutaneous emphysema without a secured airway may lead to respiratory distress, respiratory depression, airway obstruction, tracheal deviation, and tension pneumothorax.