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Challenges of conversion from robotic surgery for vascular complications
Peter J Lau1, James M McGreevy2, Jessica A Thomes Pepin3
1Division of Vascular Surgery, University of Minnesota, Minneapolis, MN.
Summary
Robotic surgery complications can arise from improper instrument removal. Aortic injury during a robotic procedure was worsened by locked graspers, highlighting the need for specific protocols.
Area of Science:
- Surgical Technology
- Vascular Surgery
- Gynecologic Oncology
Background:
- Robotically assisted retroperitoneal lymphadenectomy is a complex procedure.
- Aortic injury is a rare but serious complication during such surgeries.
Observation:
- An aortic injury occurred during robotically assisted retroperitoneal lymphadenectomy.
- Laparoscopic repair was not feasible, necessitating conversion to open surgery.
- Robotic graspers locked, causing further aortic injury upon attempted removal.
Findings:
- Instrument malfunction during robotic surgery conversion led to secondary injury.
- Forceful removal of locked robotic hardware was required for definitive aortic repair.
- Adherence to stepwise removal algorithms for robotic instruments is critical.
Implications:
- Vascular surgeons must be trained in robotic hardware removal protocols.
- Deviations from standard robotic instrument removal can cause significant surgical challenges.
- Enhanced training is needed to mitigate risks associated with robotic surgery conversion.
