Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy
Abstract Background Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented. Case presentation A 71-year-old man underwent...
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SpringerOpen
2025-05-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-025-00793-w |
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| author | Mori Satori Mitsuhiro Matsuo Yoshinori Ikehata Hiroshi Kitamura Tomonori Takazawa |
| author_facet | Mori Satori Mitsuhiro Matsuo Yoshinori Ikehata Hiroshi Kitamura Tomonori Takazawa |
| author_sort | Mori Satori |
| collection | DOAJ |
| description | Abstract Background Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented. Case presentation A 71-year-old man underwent robotic partial nephrectomy. During tumor resection, end-tidal CO₂ (ETCO₂) decreased from 42 to 34 mmHg, followed by a decrease in mean arterial pressure (MAP) to < 65 mmHg and oxygen saturation (SpO₂) to 95%. Postoperatively, he exhibited delayed emergence from anesthesia and left conjugate gaze deviation. Neuroimaging revealed cerebral gas embolism. A bubble test performed by a cardiologist under positive pressure ventilation ruled out right-to-left shunt. Despite postoperative treatment, the patient became bedridden with severe neurological sequelae. Conclusions Cerebral gas embolism can occur during robotic procedures even without right-to-left shunt. Anesthesiologists must promptly recognize intraoperative signs of this complication and initiate timely interventions to prevent severe complications. |
| format | Article |
| id | doaj-art-6f2ca5bbbe1b4e4f9b6f6aad2d55fb34 |
| institution | OA Journals |
| issn | 2363-9024 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj-art-6f2ca5bbbe1b4e4f9b6f6aad2d55fb342025-08-20T02:29:26ZengSpringerOpenJA Clinical Reports2363-90242025-05-011111510.1186/s40981-025-00793-wCerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomyMori Satori0Mitsuhiro Matsuo1Yoshinori Ikehata2Hiroshi Kitamura3Tomonori Takazawa4Department of Anesthesiology, University of ToyamaDepartment of Anesthesiology, University of ToyamaDepartment of Urology, University of ToyamaDepartment of Urology, University of ToyamaDepartment of Anesthesiology, University of ToyamaAbstract Background Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented. Case presentation A 71-year-old man underwent robotic partial nephrectomy. During tumor resection, end-tidal CO₂ (ETCO₂) decreased from 42 to 34 mmHg, followed by a decrease in mean arterial pressure (MAP) to < 65 mmHg and oxygen saturation (SpO₂) to 95%. Postoperatively, he exhibited delayed emergence from anesthesia and left conjugate gaze deviation. Neuroimaging revealed cerebral gas embolism. A bubble test performed by a cardiologist under positive pressure ventilation ruled out right-to-left shunt. Despite postoperative treatment, the patient became bedridden with severe neurological sequelae. Conclusions Cerebral gas embolism can occur during robotic procedures even without right-to-left shunt. Anesthesiologists must promptly recognize intraoperative signs of this complication and initiate timely interventions to prevent severe complications.https://doi.org/10.1186/s40981-025-00793-wCarbon dioxideCase reportGas embolismParadoxical embolismNephrectomy |
| spellingShingle | Mori Satori Mitsuhiro Matsuo Yoshinori Ikehata Hiroshi Kitamura Tomonori Takazawa Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy JA Clinical Reports Carbon dioxide Case report Gas embolism Paradoxical embolism Nephrectomy |
| title | Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy |
| title_full | Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy |
| title_fullStr | Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy |
| title_full_unstemmed | Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy |
| title_short | Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy |
| title_sort | cerebral gas embolism in a patient without right to left shunt after robotic partial nephrectomy |
| topic | Carbon dioxide Case report Gas embolism Paradoxical embolism Nephrectomy |
| url | https://doi.org/10.1186/s40981-025-00793-w |
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