DETROIT There may be warning signs to help surgeons avoid damaging part of the urinary system during robot-assisted surgical removal of prostate cancer, ultimately preventing the expense of additional surgery, according to researchers at Henry Ford's Vattikuti Urology Institute.
Although rare, they found instances when the ureter tubes that carry urine from the kidneys to the bladder were cut and required repair. In each case, they identified patient characteristics that may forewarn such damage. The study was recently published in the Journal of Endourology.
The study drawing from Henry Ford Hospital's experience with robot-assisted surgery removal of prostate cancer was conducted in the context of a steady rise in robot-assisted prostatectomies in the U.S. during the past decade.
Robotics permit surgeons to better visualize anatomy, control bleeding, have greater dexterity, and treat prostate cancers more effectively without complications than was previously possible in traditional open surgery.
While practitioners have reported various complications during the procedure, little data existed prior to this study regarding injuries to the ureter during robotic prostatectomy.
Under guidance of Drs. Mani Menon and James Peabody, a research team at Henry Ford's Vattikuti Urology Institute focused on 6,442 consecutive patients who underwent robotic prostatectomy by one of five surgeons at the hospital from January 2001 to June 2013.
"We found three patients in the study group, operated on by two of the five surgeons, who sustained complete transection of the ureter, although these surgeons were highly experienced, having performed more than 1,000 robotic prostatectomies," says Jay Jhaveri, M.D., M.P.H., lead author of the study. "This is well beyond the accepted learning curve of 100 cases."
"One of the patients required readmission for further treatment, and we were able to identify risk factors that predisposed all of them
|Contact: Dwight Angell|
Henry Ford Health System