Incidencias y complicaciones en nuestras primeras 250 prostatéctomias radicales robóticas

Arias, J.G. Pereira; Quintanilla, M. Gamarra; Tamayo, Aracely; Odriozola, A. Astobieta; González, G. Ibarluzea

doi:10.1016/j.acuro.2009.12.007

Cited by 18 publications

(6 citation statements)

References 38 publications

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“…In contrast to decreases in conversion, it seems that patient damage by RM is relatively increased. Whereas before 2009 only one casualty was described among 9 cases of patient damage in 189 adverse events [ 9 ], after 2010 Pereyra et al [ 15 ] and Mues et al [ 17 ] describe 4 and 3 RM related damages, respectively. The latter number only describes instrument failure related RMs, and all three damages were major complications (iliac vein lesions, ileal perforation, and urethral cauterization).…”

Section: Discussionmentioning

confidence: 99%

Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view

Ferrarese¹,

Pozzi²,

Borghi³

et al. 2016

Open Medicine

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AbstractRobotic surgery (RS) technology has undergone rapid growth in the surgical field since its approval. In clinical practice, failure of robotic procedures mainly results from a surgeon’s inability or to a device malfunction. We reviewed the literature to estimate the impact of this second circumstance in RS and its consequent legal implications. According to data from the literature, device malfunction is rare. We believe it is necessary to complement surgical training with a technical understanding of RS devices.

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Section: Discussionmentioning

confidence: 99%

Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view

Ferrarese¹,

Pozzi²,

Borghi³

et al. 2016

Open Medicine

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“…Yi et al [10] recently reported 4 further cases of metal clip migration after RRP; two resulted in stone formation and the other two into BNC. There are few reports of hem-o-lok clip migration into the urinary tract leading to spontaneous expulsion, urethral erosion, bladder stone formation and bladder neck contracture [1-7]. These findings would suggest that the use of clips in proximity of the vesico-urethral anastomosis should be limited if not avoided, and that the occurrence of de novo voiding symptoms in patients having undergone radical prostatectomy should rise the suspect of clip-related complications.…”

Section: Case Presentationmentioning

confidence: 99%

“…Their migration into the urinary tract has already been described [1-7], presenting with spontaneous expulsion, urethral erosion, bladder stone formation and even bladder neck contracture (BNC). There is no previous report of stress urinary incontinence (SUI) following removal of a migrated hem-o-lok clip.…”

Section: Introductionmentioning

confidence: 99%

Hem-O-Lok clip: a neglected cause of severe bladder neck contracture and consequent urinary incontinence after robot-assisted laparoscopic radical prostatectomy

et al. 2014

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BackgroundHem-o-lok clips are widely used during robot-assisted and laparoscopic radical prostatectomy to control the lateral pedicles. There are a few reports of hem-o-lok clip migration into the bladder or vesico-urethral anastomosis and only four cases of hem-o-lok clip migration resulting into bladder neck contracture. Herein, we describe the first case, to our knowledge, of hem-o-lok clip migration leading to severe bladder neck contracture and subsequent stress urinary incontinence.Case presentationA 62-year-old Caucasian man underwent robot-assisted laparoscopic radical prostatectomy for a T1c Gleason 8 prostate cancer. One month after surgery the patient was fully continent; however, three months later, he presented with acute urinary retention requiring suprapubic drainage. Urethroscopy showed a hem-o-lok clip strongly attached to the area between the vesico-urethral anastomosis and the urethral sphincter and a severe bladder neck contracture behind it. Following cold-knife urethral incision and clip removal, the bladder neck contracture was widely resected. At 3-month follow-up, the patient voided spontaneously with a peak flow rate of 9.5 ml/sec and absence of post-void residual urine, but leaked 240 ml urine at the 24-hour pad test. To date, at 1-year follow-up, his voiding situation remains unchanged.ConclusionsThe present report provides further evidence for the risk of hem-o-lok clip migration causing bladder neck contracture, and is the first to demonstrate the potential of such complication to result into stress urinary incontinence.

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“…In order to decrease the rate of lymphocele, meticulous lymphostasis is critical and can be achieved with the use of titanium clips. Unfortunately, significant complications have been associated with the use of common non-absorbable clips including clip migration into the bladder and rectum following RP ( 30 ). All of these complications required additional procedures for clip removal with some leading to permanent functional impairment.…”

Section: Developing a Personalized Template For Lnd In Capmentioning

confidence: 99%

Developing a personalized template for lymph node dissection during radical prostatectomy

Pathak

Hemal

2018

Transl. Androl. Urol.

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Lymph node dissection (LND) represents a critical step in order to determine lymph node invasion (LNI), not only for prognostic means but also as a therapeutic strategy in the management of patients with prostate cancer (CaP). Indications for performing LND are inconsistent with the American Urologic Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) recommendations differing. A thorough appreciation of lymph node drainage patterns and extent of LND has reshaped our understanding of this disease. Moreover, newer research into this field has directly resulted in refinements to current nomograms with utilization of various prostate-specific antigen (PSA) parameters and genomic medicine. Lastly, the application of newer imaging modalities in combination with molecular-guided robotic surgery has personalized the approach of LND espousing excellent safety, efficacy, and oncologic outcomes in these patients.

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Incidencias y complicaciones en nuestras primeras 250 prostatéctomias radicales robóticas

Cited by 18 publications

References 38 publications

Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view

Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view

Hem-O-Lok clip: a neglected cause of severe bladder neck contracture and consequent urinary incontinence after robot-assisted laparoscopic radical prostatectomy

Developing a personalized template for lymph node dissection during radical prostatectomy

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