Complications of robot-assisted prostatectomy

Zemlyanoy A.B., Magomedov Sh.S., Khanaliev B.V.

Mini-invasive surgical treatments, such as robot-assisted laparoscopic surgery, have been developed to reduce surgical aggression. Robot-assisted radical prostatectomy (RARP) reduced the number of complications in the perioperative period compared to open interventions. However, as the number of operations performed using the da Vinci system increases, the number of other complications, including iatrogenic ones, also increases. At the same time, at the stages of mastering the technique, RARP is performed significantly longer than laparoscopic prostatectomy and retropubic prostatectomy.

This literature review presents an analysis of complications, including rare ones, associated with RARP. Recent major domestic and foreign studies and meta-analyses were analyzed to assess the frequency, pathogenesis of development, and methods for correcting the most common complications. The most common complications of RARP are urinary incontinence and erectile dysfunction in 16–20% and 70–90% of cases, respectively, according to different data. Other relatively common complications (about 2% of cases), such as stricture of vesicourethral anastomosis, failure of vesicourethral anastomosis, lymphocele and bleeding in the area of surgery can be corrected surgically without consequences for the quality of life of the patient. Separately, a group of complications that occur outside the operating field, such as peripheral nerve damage, deep vein thrombosis of the legs, ophthalmic complications, rhabdomyolysis, and complications associated with insufflation should be distinguished. These complications occur only in 0,1% of cases and require a multidisciplinary approach involving related specialists.

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