Nerve Damage Reported in Patient Who Underwent Prostatectomy With Da Vinci Robot

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A 65-year-old man who recently underwent a laparoscopic prostatectomy with a da Vinci Surgical Robot allegedly suffered serious nerve damage, according to The Expert Institute, a popular business development engine. In addition to widespread reports of nerve damage, the da Vinci Robot has been linked to injuries to internal organs such as the liver, rectum, spleen, and heart. Since 2009 alone, the surgical robot has been associated with more than 70 deaths.

Da Vinci Robot Recall March 25, 2014: Intuitive Surgical has issued a nationwide recall for certain cannulae components used with the da Vinci Robot, due to the risk that the parts may be damaged during use and could be hard to replace. To date, at least one patient has experienced injuries that may have been caused by a damaged cannula, which occurred when the tube rotated and punctured the patient’s abdomen.

What’s the Problem?

According to The Expert Institute Report, the patient who underwent the prostatectomy with the da Vinci Robot was placed in the lithotomy position with his arms tucked to the side and his hands insulated by foam pads. The medical team then secured the patient’s head and shoulders while placing his legs in stirrups, and then tipped him back into the Trendelenburg position before making the first incision.

During the course of the procedure, the surgeon had trouble finding the vas deferens and seminal vesicles, so another doctor was called in to help. The patient stayed in the Trendelenburg position for a period of more than six hours.

When the patient was transferred to the Post-anesthesia care unit (PACU), a nurse noticed that his head and face were swollen, and there were strap marks and blisters on his arms from a blood pressure cuff that was left contracted for a prolonged period of time. The patient described numbness and tingling in his arms and hands, as well as pain from the shoulders down. Electromyography (EMG) and neurological exams revealed nerve injuries from compression.

A subsequent report filed by a hand surgeon noted that the nerve damage was likely to have been caused by the robot-assisted prostatectomy. The patient underwent several minimally successful followup surgeries in an effort to correct the nerve damage.

How can da Vinci Robot complications be avoided?

The da Vinci Robot is an extremely complicated device that requires upwards of 200 surgeries for an operator to become proficient at. Research has shown improvement in laparoscopic skills with lab drills and simulation procedures. This type of training improves accuracy, decreases errors, results in a shorter learning curve, and increases the speed of performing the operations. Because of these factors, questions arise about how to train and credential robotic surgeons in the most appropriate manner. Generally speaking, the certification process can only be approved by the institution where the surgeon is employed, and must be based on aspects of technical training, capability, and documented robotic surgery cases. Additionally, training should incorporate how to respond to device malfunctions and how to quickly remove the device from patients if an emergency arises.

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