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Prevention and Management of Complications During Robotic-Assisted Laparoscopic Radical Prostatectomy

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Robotic Urologic Surgery

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Abstract

The recent introduction of the da Vinci® Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) to the field of urologic surgery has added new hopes of reducing morbidity and the learning curve for minimally invasive radical prostatectomy due to its technological peculiarities, such as three-dimensional (3D) vision, 7 degrees of freedom, and magnification. However, as expected, the introduction of any innovative technology or surgical procedure is associated with an initial learning curve and with the potential of eliciting new risks and surgical complications. To date, few series have evaluated the risk of complications following robotic-assisted radical prostatectomy (RARP), despite the publication of several studies reporting perioperative data and early functional and oncologic outcomes related to the procedure. Even fewer studies have used standardized systems to classify surgical complications, which has hampered accurate comparisons between different series or surgical approaches. In this chapter we discuss surgical complications after RARP and how to prevent them. Patient positioning, port placement, and intraoperative and postoperative complications are addressed. Complication rates in the RARP series currently available in the literature are also analyzed.

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References

  1. Reiner WB, Walsh PC. An anatomical approach to the surgical management of the dorsal vein and Santorini’s plexus during radical retropubic surgery. J Urol. 1979;121:198-200.

    PubMed  CAS  Google Scholar 

  2. Bill-Axelson A, Holmberg L, Ruutu M, et al. Scandinavian prostate cancer group study, 4. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med. 2005;12:1977-1984.

    Article  Google Scholar 

  3. Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. 1997;50:854-857.

    Article  PubMed  CAS  Google Scholar 

  4. Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy. BJU Int. 2001;87:408-410.

    Article  PubMed  CAS  Google Scholar 

  5. Vickers AJ, Savage CJ, Hruza M, et al. The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol. 2009;10:475-480.

    Article  PubMed  Google Scholar 

  6. Appledorn SV, Costello AJ. Complications of robotic surgery and how to prevent them. In: Patel VR, ed. Robotic Urologic Surgery. London: Springer; 2007. Limited.

    Google Scholar 

  7. Litwiller JP, Wells RE Jr, Halliwill JR, et al. Effect of lithotomy positions on strain of the obturator and lateral femoral cutaneous nerves. Clin Anat. 2004;17:45-49.

    Article  PubMed  Google Scholar 

  8. Wolf S Jr, Marcovich R, Inderbir S, Gill IS. Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery. Urology. 2000;55(6):831-836.

    Article  PubMed  Google Scholar 

  9. Gill I, ed. Textbook of Laparoscopic Urology; Section IX, Laparoscopic Complications: Etiology, Prevention, Management. 1st ed. NY: Infroma Healthcare USA; 2006: chap. 80, 81, 82, 83.

    Google Scholar 

  10. Chandler JC, Corson SL. Three spectra of laparoscopic entry access injuries. J Am Coll Surg. 2001;192:478-491.

    Article  PubMed  CAS  Google Scholar 

  11. Murphy DG, Kerger M, Crowe H, Peters JS, Costello AJ. Operative details and oncological and functional outcome of robotic-assisted laparoscopic radical prostatectomy: 400 cases with a minimum of 12 months follow-up. Eur Urol. 2009;55:1358-1367.

    Article  PubMed  Google Scholar 

  12. Novara G, Ficarra V, D’Elia C, Secco S, Cavalleri S, Artibani W. Prospective evaluation with standardised criteria for postoperative complications after robotic-assisted laparoscopic radical prostatectomy. Eur Urol. 2010;57(3):363-370.

    Article  PubMed  Google Scholar 

  13. Hu JC, Nelson RA, Wilson TG, et al. Perioperative complications of laparoscopic and robotic assisted laparoscopic radical prostatectomy. J Urol. 2006;175:541-546.

    Article  PubMed  Google Scholar 

  14. Vasilev SA. Obturator nerve injury: a review of management options. Gynecol Oncol. 1994;53:152-155.

    Article  PubMed  CAS  Google Scholar 

  15. Patel VR. Clinical pearls: the approach to the management of difficulty anatomy and common operative and postoperative problems. In: Patel VR, ed. Robotic Urologic Surgery. London: Springer; 2007.

    Chapter  Google Scholar 

  16. Bhandari A, McIntire L, Kaul SA, et al. Perioperative complications of robotic radical prostatectomy after the learning curve. J Urol. 2005;174:915-918.

    Article  PubMed  Google Scholar 

  17. Bentas W, Wolfram M, Jones J, et al. Robotic technology and the translation of open radical prostatectomy to laparoscopy: the early Frankfurt experience with robotic radical prostatectomy and one year follow-up. Eur Urol. 2003;44:175-181.

    Article  PubMed  Google Scholar 

  18. Costello AJ, Haxhimolla H, Crowe H, et al. Instillation of telerobotic surgery and initial experience of telerobotic prostatectomy. BJU Int. 2005;96:34-38.

    Article  PubMed  Google Scholar 

  19. Koya MP, Manoharan M, Kim SS, et al. Venous thromboembolism in radical prostatectomy: is heparinoid prophylaxis warranted? BJU Int. 2005;96:1019-1021.

    Article  PubMed  Google Scholar 

  20. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205-213.

    Article  PubMed  Google Scholar 

  21. Coelho RF et al. Early complication rates in a single-surgeon series of 2500 robotic-assisted radical prostatectomies: report applying a standardized grading system. Eur Urol. 2010;57(6):945-952. doi:10.1016/j.eururo.2010.02.001.

    Article  PubMed  Google Scholar 

  22. Joseph JV, Rosenbaum R, Madeb R, Erturk E, Patel HR. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol. 2006;175:945-950.

    Article  PubMed  CAS  Google Scholar 

  23. Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 2007;110:1951-1958.

    Article  PubMed  Google Scholar 

  24. Mottrie A, Van Migem P, De Naeyer G, Schatteman P, Carpentier P, Fonteyne E. Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases. Eur Urol. 2007;52:746-750.

    Article  PubMed  Google Scholar 

  25. Rozet F, Jaffe J, Braud G, et al. A direct comparison of robotic assisted versus pure laparoscopic radical prostatectomy: a single institution experience. J Urol. 2007;178:478-482.

    Article  PubMed  Google Scholar 

  26. Nelson B, Kaufman M, Broughton G, et al. Comparison of length of hospital stay between radical retropubic prostatectomy and robotic assisted laparoscopic prostatectomy. J Urol. 2007;177:929-931.

    Article  PubMed  Google Scholar 

  27. Schroeck FR, Sun L, Freedland SJ, et al. Comparison of prostate-specific antigen recurrence-free survival in a contemporary cohort of patients undergoing either radical retropubic or robot-assisted laparoscopic radical prostatectomy. BJU Int. 2008;102:28-32.

    Article  PubMed  Google Scholar 

  28. Chan RC, Barocas DA, Chang SS, et al. Effect of a large prostate gland on open and robotically assisted laparoscopic radical prostatectomy. BJU Int. 2008;101:1140-1144.

    Article  PubMed  Google Scholar 

  29. Zorn KC, Wille MA, Thong AE, et al. Continued improvement of perioperative, pathological and continence outcomes during 700 robot-assisted radical prostatectomies. Can J Urol. 2009;16:4742-4749.

    PubMed  Google Scholar 

  30. Krambeck AE, DiMarco DS, Rangel LJ, et al. Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int. 2008;103:448-453.

    Article  PubMed  Google Scholar 

  31. Ficarra V, Novara G, Artibani W, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55:1037-1063.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Global Robotics Institute – Urology, Florida Hospital Celebration Health, Celebration, FL, USA

    Rafael Ferreira Coelho M.D.

  2. Florida Hospital Celebration Health Global Robotics Institute, Celebration, FL, USA

    Kenneth J. Palmer M.D. & Vipul R. Patel M.D.

  3. Department of Urology, La Floresta Medical Institute, Caracas, Distrito Federal, Venezuela

    René Javier Sotelo Noguera M.D.

  4. Florida Hospital Global Robotics Institute Florida Hospital Celebration Health, Celebration, FL, USA

    Vipul R. Patel M.D.

  5. University of Central Florida College of Medicine, Florida Hospital Celebration Health, Celebration, FL, USA

    Vipul R. Patel M.D.

Authors
  1. Rafael Ferreira Coelho M.D.
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  2. Kenneth J. Palmer M.D.
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  3. René Javier Sotelo Noguera M.D.
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  4. Vipul R. Patel M.D.
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Editor information

Editors and Affiliations

  1. Florida Hospital Celebration Health, Global Robotics Institute, Celebration Place 410, Celebration, 34747, Florida, USA

    Vipul R. Patel

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© 2011 Springer-Verlag London Limited

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Coelho, R.F., Palmer, K.J., Noguera, R.J.S., Patel, V.R. (2011). Prevention and Management of Complications During Robotic-Assisted Laparoscopic Radical Prostatectomy. In: Patel, V. (eds) Robotic Urologic Surgery. Springer, London. https://doi.org/10.1007/978-1-84882-800-1_21

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  • DOI: https://doi.org/10.1007/978-1-84882-800-1_21

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-799-8

  • Online ISBN: 978-1-84882-800-1

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