The uptake of robotic surgery has led to changes in potential operative complications, as many surgeons learn minimally invasive surgery, and has allowed the documentation of such complications through the routine collection of intraoperative video.
We documented intraoperative complications from robot-assisted radical prostatectomy (RARP) with the aim of reporting the mechanisms, etiology, and necessary steps to avoid them. Our goal was to facilitate learning from these complications to improve patient care.
Contributors delivered videos of complications that occurred during laparoscopic and robotic prostatectomy between 2010 and 2015.
Surgical footage was available for a variety of complications during RARP.
Based on these videos, a literature search was performed using relevant terms (prostatectomy, robotic, complications), and the intraoperative steps of the procedures and methods of preventing complications were outlined.
As a major surgical procedure, RARP has much potential for intra- and postoperative complications related to patient positioning, access, and the procedure itself. However, with a dedicated approach, increasing experience, a low index of suspicion, and strict adherence to safety measures, we suggest that the majority of such complications are preventable.
Considering the complexity of the procedure, RARP is safe and reproducible for the surgical management of prostate cancer. Insight from experienced surgeons may allow surgeons to avoid complications during the learning curve.
Robot-assisted radical prostatectomy has potential for intra- and postoperative complications, but with a dedicated approach, increasing experience, a low index of suspicion, and strict adherence to safety measures, most complications are preventable.
European urology. 2015 Sep 15 [Epub ahead of print]
René J Sotelo, Alexander Haese, Victor Machuca, Luis Medina, Luciano Nuñez, Flavio Santinelli, Andrés Hernandez, Ali Riza, Alexander Mottrie, Camilo Giedelman, Mariano Mirandolino, Kenneth Palmer, Ronney Abaza, Reza Ghavamian, Arieh Shalhav, Alireza Moinzadeh, Vipul Patel, Michael Stifelman, Ingolf Tuerk, David Canes
Center of Robotics and Minimally Invasive Surgery, Instituto Médico La Floresta, Caracas, Venezuela; University of Southern California, Los Angeles, CA, USA. Martini Clinic Prostate Cancer Center, University Clinic Eppendorf, Hamburg, Germany. , Center of Robotics and Minimally Invasive Surgery, Instituto Médico La Floresta, Caracas, Venezuela. , Center of Robotics and Minimally Invasive Surgery, Instituto Médico La Floresta, Caracas, Venezuela. , Center of Robotics and Minimally Invasive Surgery, Instituto Médico La Floresta, Caracas, Venezuela. , Hospital Evita Pueblo, Buenos Aires, Argentina. , Hope Urology Center, Mexico. , Acibadem Maslak Hospital, Sarıyer, Turkey. , OVL Hospital, Aalst, Belgium. , Marly Clinic, Bogota, Colombia. , Centro Clinico Mae de Deus, Porto Alegre, Brazil. , Global Robotics Institute, Celebration, FL, USA. , Ohio State University Wexner Medical Center, Columbus, OH, USA. , Montefiori Medical Center, Bronx, NY, USA. , Duchossois Center for Advanced Medicine, Chicago, IL, USA. , Lahey Hospital and Medical Center Institute of Urology, Burlington, MA, USA. , Global Robotics Institute, Celebration, FL, USA. , New York University Langone Medical Center, New York, NY, USA. , St. Elizabeth's Medical Center, Brighton, MA, USA. , Lahey Hospital and Medical Center Institute of Urology, Burlington, MA, USA.