Urology Expert Witness Discusses Robotic Surgery Error

ByDr. Faiza Jibril

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Updated onOctober 30, 2017

Urology Expert Witness Discusses Robotic Surgery Error

This case involves a sixty-five-year-old male patient who had a new onset prostate cancer and underwent a robotic assisted prostatectomy that was met with significant complication. The patient had a prior history of an exploratory laparotomy with extensive gastrointestinal manipulation and resection of bowel tissue with a holmium laser enucleation. During the prostatectomy, the surgical note detailed great difficulty maneuvering within the abdomen due to adhesions and problems placing the patient in a standard prostatectomy position. There was also mention of proper insufflation issues that prevented a proper window into the surgical workspace. Ultimately, due to the robotic surgery, the patient sustained a perforation to the small bowel that needed to be resected with a reanastomosis required during a corrective exploratory laparotomy procedure. The patient suffered from complications linked to a very large surgical wound that would not heal for an extended time period.

Question(s) For Expert Witness

1. What is the most common complication related to laparoscopic prostatectomy procedures?

Expert Witness Response E-005320

inline imageObtaining access to the intraperitoneal or extraperitoneal space for LRP or RALP is associated with specific risks based on the type of trocars used, the location of access, patient anatomy, and prior abdominal surgery. In LRP or RALP, initial access is typically in the periumbilical location and is based on surgeon preference. Bleeding related to trocar placement is the most common access-related complication. The majority of bleeding resulting from trocar placement is due to injury of small subcutaneous veins. Most of these injuries are immediately recognized upon trocar insertion or removal, and are easily controlled with the use of electrocautery. Less frequently, larger intra-abdominal or pelvic vessels can be injured during laparoscopic access. Careful attention to proper laparoscopic technique can help prevent these injuries.

About the author

Dr. Faiza Jibril

Dr. Faiza Jibril

Dr. Faiza Jibril has extensive clinical experience ranging from primary care in the United Kingdom, to pediatrics and child abuse prevention at Mount Sinai Hospital, to obstetrics in Cape Town, South Africa. Her post-graduate education centered on clinical research and medical ethics. Dr. Jibril is currently Head of Sales in the US and Canada for Chambers and Partners - a world leading legal ranking and insights intelligence company.

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