Robotic repair of vaginal evisceration after hysterectomy and the role of intraoperative near-infrared fluorescence imaging

Abstract

Vaginal evisceration of the small bowel is a rare and potentially life-threatening complication after hysterectomy. This complication requires prompt surgical management and methods of surgical repair include abdominal, vaginal or laparoscopic approaches. We report the first case of robotic approach for repair of vaginal evisceration and intraoperative use of near-infrared fluorescence imaging for the assessment of bowel perfusion in a 63-year-old postmenopausal woman with a history of robotic hysterectomy for cervix cancer. This case demonstrates the safety and feasibility of robotic surgery and the advantage of using intraoperative near-infrared fluorescence imaging for bowel perfusion, a critical factor for surgical decision-making.