Robotic Management of Superior Mesenteric Artery Syndrome

Overview

Journal J Surg Case Rep

Publisher Oxford University Press

Specialty General Surgery

Date 2024 Apr 12

PMID 38605691

Authors

Santiago A Munoz-Palomeque

Ariadna Tobar-Tinoco

Maximo V Torres-Guaicha

Tabata L Tinoco-Ortiz

Affiliations

Soon will be listed here.

Abstract

Wilkie's syndrome is an unusual cause of upper intestinal obstruction due to mechanical compression of the superior mesenteric artery (SMA) to the duodenum, with nonspecific symptoms, whose diagnosis is confirmed by angiotomography. Initially, the treatment is conservative to regain weight and restore mesenteric adipose tissue, associated with postural changes of the patient. If this fails, surgical treatment is indicated, being laparoscopic duodenojejunostomy described as the gold standard. Robotics' assistance is feasible and safe to carry out the procedure. We present the case of a 21-year-old male patient who comes with stabbing abdominal pain and persistent postprandial vomiting that has caused weight loss of 11 kilograms in the last 2 years without apparent cause, associated with gastroesophageal reflux. During the procedure, we evidenced open diaphragmatic pillars and duodenal compression due to SMA, and robotic-assisted laparoscopic hyatoplasty + Nissen fundoplication + duodenojejunostomy were performed without complications, with excellent post-surgical results.

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