Robot-assisted laparoscopic nephrectomy for fish bone-induced perforation from the descending colon into a renal cyst: A case report

Fish bone ingestion is common in Japan, but gastrointestinal perforation is rare. We report a 67-year-old man with a fish bone perforating the descending colon and penetrating a renal cyst, causing severe retroperitoneal infection. CT revealed a linear hyperdense structure extending into the cyst with intralesional gas. Conservative therapy failed, and robot-assisted laparoscopic surgery was performed, including fish bone removal, colonic serosal repair, and nephrectomy. Recovery was uneventful, and the patient remained recurrence-free at 6 months. This is the first report of robot-assisted laparoscopic management of fish bone-induced colonic perforation with renal involvement. • Fish bone perforation of colon with renal cyst involvement is extremely rare. • CT imaging was crucial for detecting the foreign body and guiding treatment. • Robot-assisted laparoscopic surgery enabled safe removal and nephrectomy. • First reported case of robotic management for fish bone-induced renal involvement.