Recurrent sigmoid volvulus after robotic-assisted laparoscopic prostatectomy

A 73-year-old man underwent uncomplicated robotic-assisted laparoscopic prostatectomy (RALP). Nineteen days later, he developed constipation, obstipation, and distension. Imaging confirmed sigmoid volvulus, and he was subsequently managed with endoscopic detorsion. Recurrence occurred two months later, requiring colectomy.

Sigmoid volvulus has not been reported after RALP. RALP may contribute to sigmoid volvulus due to operative patient positioning, pneumoperitoneum, and mesenteric mobilization. Clinicians should be aware of this potential complication, particularly in elderly patients with predisposing anatomical factors. Consideration may be needed to laterally repair any sigmoid released during dissection in RALP.