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Complications in Robot-Assisted Renal Surgery

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Robotic Urologic Surgery

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Abstract

Introduction: During the last decade, the progressive introduction of robotic assistance for renal surgery has led to a general improvement of postoperative outcomes. However, despite its advantages, robotic surgery is not devoid of complications. In this chapter we describe the identification, prevention, and management of the most common complications associated with the robotic approach to renal surgery.

Main body of the chapter: Proper patient positioning is the first step to avoid complications in robotic renal surgery. Indeed, skin lesions and nerve injury can be easily prevented through correct patient positioning. During trocar placement, an adverse and unrecognized bowel or vascular injury can cause serious impacts on the patient’s health during or after the surgery. In this scenario, it is crucial to inspect the whole abdominal with the robotic or laparoscopic scope. Intraoperatively, a careful dissection and isolation of the kidney is crucial to avoid accidental injury of the liver, spleen, or pancreas. Similarly, detailed preoperative planning and imaging revision is fundamental to avoid accidental vascular injury during the hilum isolation. When they occur, it is necessary to have a properly trained OR team to manage it. Patient selection and preoperative counselling and prophylaxis are of critical importance to reduce the risk of some postoperative complications, such as acute kidney injury, thromboembolism, or ocular complications.

Conclusion: Patient’s selection, adequate positioning, mentorship training during the learning curve, and avoiding last-longing procedures are key steps to prevent robot-assisted-related complications. Indeed, since most of the complications may happen at the beginning of a surgeon learning curve, console and team training outside the operatory room represents a crucial step to reduce the risk of experiencing complications related to robotic approach.

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Author information

Authors and Affiliations

  1. AdventHealth Global Robotics Institute, Celebration, FL, USA

    Marcio Covas Moschovas

  2. ORSI Academy, Melle, Belgium

    Marcio Covas Moschovas, Elio Mazzone & Alexandre Mottrie

  3. University of Central Florida, UCF, Orlando, USA

    Marcio Covas Moschovas

  4. Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Elio Mazzone

  5. OLV Hospital, Aalst, Belgium

    Alexandre Mottrie

Authors
  1. Marcio Covas Moschovas
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  2. Elio Mazzone
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  3. Alexandre Mottrie
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Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA

    Peter Wiklund

  2. Department of Urology, ORSI Academy, Aalst, Belgium

    Alexandre Mottrie

  3. Pediatric Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Mohan S Gundeti

  4. Urology, Global Robotics Institute, Celebration, FL, USA

    Vipul Patel

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Moschovas, M.C., Mazzone, E., Mottrie, A. (2022). Complications in Robot-Assisted Renal Surgery. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_50

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  • DOI: https://doi.org/10.1007/978-3-031-00363-9_50

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