During the Setbacks and Operative Solutions (S.O.S.) session on Monday afternoon, several experts will challenge attendees to think critically about the potential complications of robotic prostatectomy and how to solve them.
Raju Thomas, MD, MHS, FACS, Director of Endourology, Laparoscopy and Robotic Surgery at Tulane University School of Medicine, will moderate the S.O.S. session Robotic Prostatectomy, which will begin at 4 p.m. in Ballroom West of the Boston Convention and Exhibition Center. The session’s panelists will address dorsal vein bleeding and rectal injury, the two common complications that can occur during the procedure.
“Radical prostatectomy is still the preferred mode of treatment for clinically localized and potentially curable prostate cancer,” Dr. Thomas said. “In the U.S. today the vast majority of these procedures are done with the da Vinci® robot, which has created challenges and debates about patient safety and appropriate outcomes. Robotic prostatectomy is a challenging procedure because not all prostates are created equal. When we are operating deep in the pelvis, these variables can be a challenge.”
Dr. Thomas will be joined by panelists Matthew T. Gettman, professor of Urology at the Mayo Clinic; Ketan K. Badani, MD, professor of Urology at the Icahn School of Medicine and Director of the Comprehensive Kidney Cancer Program at Mount Sinai Health System; Robert Stein, MD, associate professor of Surgery and Co-director of Robotic Surgery at the Glickman Urological and Kidney Institute, Cleveland Clinic; and Ashok K. Hemal, MD, professor of Urology at Wake Forest Baptist Health.
The panel will address the importance of controlling the dorsal venous complex (DVC) early in the procedure, and discuss the pros and cons of different techniques.
“If the DVC is not secured and continues to bleed, it will cause complications and setbacks throughout the rest of the procedure,” Dr. Thomas said. “Significant blood loss can occur during this process. Therefore, it’s important to use techniques that will minimize blood loss and minimize complications since this dissection is close to the apex of the prostate.”
The panel will tackle another tricky, but important, step during robotic prostatectomy, which is dissecting the rectum close to the apex of the prostate. They will discuss several options for minimizing risks during this part of the procedure.
“The risk factors here are well known,” Dr. Thomas said. “This is especially true for patients with palpable disease, patients who have had extensive or multiple prostate biopsies, patients who have had radiation and for those who have had hormonal ablation treatment preoperatively.”