IPEG 2020 TOP ABSTRACT: Robotic Duodenal polypectomy in a case of Peutz-Jeghers
September 2, 2020


Presenter: Rosie Cresner

Authors: Rosie Cresner; Carmen Sofia Chacon; Simon Clarke, MR; Chelsea and Westminster Children's Hospital, London

We present a step-by-step demonstration technique of a robotic duodenal enterotomy and polypectomy. The patient was a 7y old girl with known background of Peutz Jeger’s Syndrome who presented via clinic with intermittent upper abdominal pain and non-bilious vomiting. She was dehydrated and acidotic pre-operatively due to profuse vomiting. A D1 duodenal polyp causing obstruction was seen on duodenoscopy. The base was 2.5 cm and too large to snare endoscopically. We performed a robotic enterotomy and polypectomy. 3 robotic,1 balloon accessory ports and a liver retractor were placed. The robot allowed much easier manipulation of the duodenum, retrieval and eversion of the polyp from within the lumen, and allowed easy closure of the enterotomy with 2 layer running suture. The patient had excellent uneventful recovery with reintroduction of enteral fluids 48h after the surgery and discharge on the forth post-operative day. This technique should be considered for further cases.

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