Robotic Urological Surgery in the Time of COVID-19: Challenges and Solutions

Abstract

Introduction: We assess issues and challenges in the field of robotic urological surgery during the COVID-19 pandemic, and discuss current and future solutions. Methods:We considered the relevant literature as well as clinical and surgical experience at our institution.Results: A risk-benefit assessment of each patient undergoing robotic urological surgery should be performed during the COVID-19 pandemic, which is based on the urgency of the surgery, and risk of viral diseases and transmission. Preoperative testing and symptom screening are recommended to identify patients with COVID-19. Adequate personal protective equipment for the surgical team is essential to protect patients and health care workers. Although the transmission method has not yet been identified during robotic procedures, efforts should be made to minimize the risk of aerosolization. The anesthesia method should minimize aerosolization of the virus, and negative pressure rooms are strongly preferred for COVID-19 positive patients.Conclusions: Significant challenges have emerged during the COVID-19 pandemic, which also impact the field of robotic urological surgery. Perioperative practices and surgical strategies should be adapted to overcome these challenges with the aim of minimizing risk of transmission while optimizing robotic surgical outcomes. Recommendations will continue to evolve as more data become available.

Coronavirus disease 2019 (COVID-19) and priapism: An unexplored association

“…Since priapism is an established medical emergency, its management cannot be deferred. [39,40] An obvious limitation of this systematic review was that only 15 publications were eligible for inclusion, all of which were single-patient case reports. This is understandable, as the possible association between priapism and COVID-19 has only recently been described.…”

“…The overall impact of COVID-19 has interrupted other urological surgical interventions during the pandemic, and an emphasis on giving priority to COVID-19 patients has been advocated. Since priapism is an established medical emergency, its management cannot be deferred [39,40] …”

Robots Under COVID-19 Pandemic: A Comprehensive Survey

“…Here we have compiled a list of references that detail the best practices and recommended changes to the operating theater during the COVID-19 pandemic [91] – [103] . The most notable best practices are the reduction of aerosolization during surgical procedures along with minimizing exposure to the surgical staff.…”