Venous injury during lymphadenectomy: management without laparotomy

Area of Science:

• Urology
• Surgical Innovation
• Vascular Surgery

Background:

• Robotic pelvic lymphadenectomy is a complex procedure with potential risks of venous injury.
• Managing intraoperative venous injuries during minimally invasive surgery can be challenging.

Purpose of the Study:

• To evaluate the efficacy of oxidized regenerated cellulose and fibrin sealant in managing venous injuries during robotic pelvic lymphadenectomy.

Main Methods:

• Four cases of venous injuries during robotically-assisted pelvic lymphadenectomy were identified.
• Oxidized regenerated cellulose and fibrin sealant were applied to the venotomies.
• Hemostasis was assessed after application.

Main Results:

• All four venous injuries that did not respond to pressure were successfully managed with the combined application.
• Complete hemostasis was achieved in all treated venotomies.
• No adverse sequelae were observed in the postoperative period.

Conclusions:

• The combination of oxidized regenerated cellulose and fibrin sealant is a safe and effective method for controlling venous bleeding during robotic pelvic lymphadenectomy.
• This technique offers a reliable solution for managing challenging intraoperative venous injuries in robotic surgery.