Inexperienced Surgeon Perforates Patient's Ureter

Case Overview

Following the birth of her second child, the patient underwent a complete robotic hysterectomy due to prolonged and heavy vaginal bleeding. During the procedure, the patient’s ureter was perforated causing her to subsequently develop urinoma as well as an abscess. It was alleged that the operating surgeon was not sufficiently experienced to perform this procedure.

Questions to the Urology expert and their responses

Please describe your background in urology.

I am a board-certified urological surgeon with 20+ years of experience practicing at top medical institutions. I formerly served as the chief of urology at a regional medical center, and I currently work as an associate professor of urological surgery at a major medical university. I have also authored 50+ publications in my field.

Are you familiar with urethral injuries caused by hysterectomy, bilateral salpingo-oophorectomy, or trans-obturator tape?

I am familiar with urethral injuries caused by hysterectomies, BSO, and TOT. The published rate in the literature of this ureteral injury caused during TAH/BSO is approximately 1%, and this rate has been relatively consistent over time. This usually occurs while trying to control the ovarian pedicle. Of course, the issue here is when was the injury recognized, how was it handled, and whether reasonable precautions were taken by the surgeon beforehand and/or during the operation. Did the surgeon have a co-surgeon, a proctor, or any supervision? Regarding the robot, could the device have failed intraoperatively? How did the hospital mobilize resources to the scene?

About the expert

This Board Certified Urological Surgeon has been practicing medicine for over 20 years at top medical institutions. He is a member of the American Urological Association, and has over 50 publications in the field of urology. He is the former Chief of Urology at the Regional Medical Center at Memphis, and currently is a Associate Professor of Urological Surgery at a major medical university.

E-008891

Specialties:

Urology

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

Inexperienced Surgeon Perforates Patient’s Ureter