Risks And Complications

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Risks And Complications

Any surgery carries the risk of complications, including death, which is true of robotic surgery also.

There are some risks specific to the procedure and some with the patient having other associated medical conditions.

Risks associated with any modality of surgery

  1. During surgery
    • Blood loss which may or may not need blood transfusion
    • Any inadvertent injury to organs, structure or tissue, including, but not limited to:
      • Major blood vessels
      • Hollow organs such as the bowel or bladder
      • Solid organs such as the spleen or liver
      • Nerves
    • Loss of a needle, piece of an instrument, particulate or any other object used during the surgery in the patient’s body

      Anaesthesia risks:

      • Hemodynamic shock
      • Heart attack
      • Stroke
      • Deep vein thrombosis or blood clotting in deep veins
      • Pulmonary embolism or blocked lung artery
      • Pneumonia
      • Dental injury
      • Injury to the vocal cord or other soft tissues
      • Death
  2. After surgery
    • Bleeding
    • Urinary tract infection
    • Blocked intestine or small bowel, nausea or vomiting
    • Deep vein thrombosis or blood clots in deep veins
    • Blood clot in a vessel that breaks away and travels to another part of the body like lungs or brain
    • Infection
    • Large amount of drainage from the wound or drainage which lasts for a long period of time
    • Bursting of the wound at the incision site
    • Hernia (bulging of organ or fatty tissue) at the incision site
    • Symptoms or the disease may return
    • Death

      Risks associated with da Vinci robotic assisted laparoscopic surgery

      1. During surgery
        • Surgeon may need to switch to open surgery which requires a large incision and hand-assisted surgery. This is usually due to:
          • Patient anatomy / frame
          • Severe scarring or swelling of tissues
          • Injury during surgery
          • Technical challenges
          • Cancer or disease that is more extensive than first thought
          • The patient being unable to tolerate the gas / air in the abdomen which is used to inflate the abdomen during minimally invasive surgery
        • Longer operating and anaesthesia time
        • Surgical instrument or equipment injures to hollow or solid organ(s) or blood vessel(s)
        • Short-term nerve damage caused by how the patient was positioned on the operating table
        • Temporary swelling of tissue due to gas in the tissue
        • Changes in heart rate, blood pressure or blood values due to absorption of the gas used during minimally invasive surgery
      2. After Surgery
        • Shoulder pain
        • Pain from the gas used during the surgery
      3. Others
        • Malfunction of theda Vinci ;robotic surgical system
        • System failure leading to serious injury
        • Need to switch to another type of surgical approach which could also result in longer procedure time, longer time under anaesthesia and increased complications.

          Risks associated with specific procedures in urology

          1. Radical prostatectomy (removal of the prostate gland and some surrounding tissue)
            • Leaking of urine
            • Urgent need to urinate
            • Unable to get or keep an erection
            • Rectal or bowel injury
            • Narrowing of the urethra
            • The pooling of lymph fluid in the pelvic area or legs
          2. Pyeloplasty (surgery for a urinary blockage)
            • Infection of the kidney
            • Leaking of urine
            • Narrowing of the urethra
            • Bowel injury
            • Kidney stones
            • Narrowing or movement of the stent
            • Blood in the urine
            • Prolonged leaking of urine
          3. Cystectomy (removal of all / part of the bladder)
            • Leaking of urine
            • Injury to the rectum
            • Scar tissue that causes narrowing between two connected structures
            • Fistula (abnormal bond of an organ, intestine or vessel to another part of the body)
            • Urgent need to urinate
            • Unable to get or keep an erection
            • Abnormal pooling of lymph fluid
          4. Nephrectomy (kidney removal)
            • Poor kidney function often due to limited blood flow
            • Leaking of urine
            • Cut or tear in the spleen, pancreas or liver, bowel injury
            • Trapped air between the chest wall and lung
            • Injury to the diaphragm (muscle separating the chest from the abdomen)
            • Urinary fistula (abnormal bond of an organ, intestine or vessel to another part of the body)
            • Abnormal pooling of urine
            • Limited or cut-off blood supply to kidney
            • Abnormal pooling of lymph fluid
          5. Ureteral reimplantation (repositions how ureter connects to bladder)
            • Urinary tract infection that affects one or both kidneys
            • Damage to the urethra which can cause urine to collect in other areas of the body
            • Scar tissue that causes narrowing at the site of the repair
            • Abnormal flow of urine from the bladder back to the kidneys