TY - JOUR
T1 - Safer Surgery by Learning from Complications
T2 - A Focus on Robotic Prostate Surgery
AU - Sotelo, René J.
AU - Haese, Alexander
AU - Machuca, Victor
AU - Medina, Luis
AU - Nuñez, Luciano
AU - Santinelli, Flavio
AU - Hernandez, Andrés
AU - Kural, Ali Riza
AU - Mottrie, Alexander
AU - Giedelman, Camilo
AU - Mirandolino, Mariano
AU - Palmer, Kenneth
AU - Abaza, Ronney
AU - Ghavamian, Reza
AU - Shalhav, Arieh
AU - Moinzadeh, Alireza
AU - Patel, Vipul
AU - Stifelman, Michael
AU - Tuerk, Ingolf
AU - Canes, David
N1 - Publisher Copyright:
© 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background 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. Objective 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. Design, setting, and participants Contributors delivered videos of complications that occurred during laparoscopic and robotic prostatectomy between 2010 and 2015. Surgical procedure Surgical footage was available for a variety of complications during RARP. Outcome measurements and statistical analysis 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. Results and limitations 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. Conclusions 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. Patient summary 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.
AB - Background 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. Objective 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. Design, setting, and participants Contributors delivered videos of complications that occurred during laparoscopic and robotic prostatectomy between 2010 and 2015. Surgical procedure Surgical footage was available for a variety of complications during RARP. Outcome measurements and statistical analysis 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. Results and limitations 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. Conclusions 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. Patient summary 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.
KW - Prostate
KW - Robotic surgery
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U2 - 10.1016/j.eururo.2015.08.060
DO - 10.1016/j.eururo.2015.08.060
M3 - Article
C2 - 26385157
AN - SCOPUS:84952875826
SN - 0302-2838
VL - 69
SP - 334
EP - 344
JO - European Urology
JF - European Urology
IS - 2
ER -