V1230 ROBOTIC REPAIR OF ACCESS-RELATED AORTIC INJURY

Abstract

You have accessJournal of UrologyProstate Oncology1 Apr 2011V1230 ROBOTIC REPAIR OF ACCESS-RELATED AORTIC INJURY Ronney Abaza Ronney AbazaRonney Abaza Columbus, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.888AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic surgery is becoming more widespread, but curricula for training residents in robotics have yet to be fully developed. Novice residents involved in robotic procedures expose patients being treated at academic centers to avoidable injuries. A case of major aortic injury during access for robotic radical prostatectomy and robotic repair is presented with video analysis of emergent measures taken and an analysis of factors that contributed to the event. METHODS A 57-year-old male was positioned in steep Trendelenburg for robotic prostatectomy. Veress needle insufflation was performed and all ports placed under laparoscope guidance. The robot was the brought into position and secured to the ports. The two left-sided robotic instruments were placed by the attending, but during simultaneous placement of the right-sided robotic scissors by a resident, resistant was noted. The instrument was replaced by the attending, but subsequent inspection from the console revealed brisk bleeding from the retroperitoneum. RESULTS The source of injury was identified with robotic dissection through the retroperitoneum to the level of the aorta (figure). A polypropylene suture was placed for immediate control and held with the fourth-arm instrument while dissection of the aorta at the injury was performed for controlled suture repair. The patient was admitted for observation with routine robotic prostatectomy performed the following day. CONCLUSIONS Unexpected major injuries can occur when trainees with inadequate training in robotics are involved in robotic procedures. Root cause analysis of our aortic injury has lessons for surgeons involved in training programs, who should be prepared to handle any potential. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e492-e493 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ronney Abaza Columbus, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...