Evangelou K, Polydorou A, Petropoulou T. Emergency robotic-assisted repair in an elderly patient with strangulated hernia and active influenza A infection: A case report. World J Virol 2026; 15(2): 117106 [DOI: 10.5501/wjv.v15.i2.117106]
Corresponding Author of This Article
Kyriacos Evangelou, MD, Department of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens 11527, Greece. evangeloukyriacos@gmail.com
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Surgery
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case-report
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Evangelou K, Polydorou A, Petropoulou T. Emergency robotic-assisted repair in an elderly patient with strangulated hernia and active influenza A infection: A case report. World J Virol 2026; 15(2): 117106 [DOI: 10.5501/wjv.v15.i2.117106]
World J Virol. Jun 25, 2026; 15(2): 117106 Published online Jun 25, 2026. doi: 10.5501/wjv.v15.i2.117106
Emergency robotic-assisted repair in an elderly patient with strangulated hernia and active influenza A infection: A case report
Kyriacos Evangelou, Andreas Polydorou, Thalia Petropoulou
Kyriacos Evangelou, Department of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
Kyriacos Evangelou, Thalia Petropoulou, Department of General Surgery, Aretaieion University Hospital, Athens 11528, Greece
Andreas Polydorou, Thalia Petropoulou, Department of Minimally Invasive Colon and Rectal Surgery, The Euroclinic Hospital of Athens, Athens 11521, Greece
Author contributions: Evangelou K, Polydorou A, and Petropoulou T contributed to manuscript writing and editing; Polydorou A and Petropoulou T contributed to data collection; Evangelou K contributed to data analysis; Polydorou A and Petropoulou T contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest associated with the present manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Kyriacos Evangelou, MD, Department of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens 11527, Greece. evangeloukyriacos@gmail.com
Received: November 28, 2025 Revised: February 11, 2026 Accepted: March 24, 2026 Published online: June 25, 2026 Processing time: 202 Days and 16.9 Hours
Abstract
BACKGROUND
Emergency repair of strangulated hernias in elderly patients with active respiratory viral infections is high risk and poorly described. This case reports the first emergency robotic-assisted transabdominal preperitoneal (r-TAPP) repair performed in an elderly patient with active influenza A infection, highlighting surgical and infection-control adaptations enabling safe outcomes.
CASE SUMMARY
An 80-year-old male with significant comorbidities presented with a strangulated left inguinal hernia and confirmed influenza A (H3N2) infection, associated with abdominal pain, bowel obstruction, and mild hypoxaemia. Emergency robotic r-TAPP repair was performed using targeted modifications, including ultra-low-pressure pneumoperitoneum, ultra-low particulate air filtration, and lung-protective ventilation. Operative time was 85 minutes with minimal blood loss. The patient was extubated immediately postoperatively, experienced no complications, and was discharged on postoperative day two. Antiviral therapy was continued without respiratory deterioration or nosocomial transmission.
CONCLUSION
Emergency robotic-assisted repair of strangulated hernia can be safely performed in selected elderly patients with active respiratory viral infection when appropriate surgical, anaesthetic, and infection-control strategies are applied.
Core Tip: This case demonstrates the safe and feasible use of emergency robotic-assisted surgery for strangulated hernia transabdominal preperitoneal repair in an elderly patient with an active influenza A (H3N2) infection. Key modifications in surgical approach, anaesthesia, and infection control (such as ultra-low-pressure pneumoperitoneum, ultra-low particulate air filtration, and lung-protective ventilation) were implemented to reduce postoperative complications. The case provides valuable insights into managing high-risk surgical patients with active respiratory viral infections, offering a model for future emergency robotic-assisted surgeries during potential future viral pandemics.
