Man Suffers Bowel Perforation, Sepsis After Robotic-Assisted Surgery

Case Overview

This case involves a middle-aged male patient in New Mexico who suffered complications after undergoing a robotic-assisted prostatectomy in order to treat early-stage prostate cancer. The surgery was performed with the assistance of a da Vinci robotic surgical technology, which was noted to have taken place without complications. However, unbeknownst to the operating physician, the patient had suffered a perforation of his small bowel during the course of the procedure. Several hours after the conclusion of the procedure, the patient began to complain of severe abdominal pain. In response, the patient was moved to the intensive care unit, where it was noted that his condition continued to deteriorate. It was eventually discovered that the man had developed a serious infection as well as sepsis, forcing the man to remain in the hospital for several months and to undergo extensive rehabilitation for the better part of a year.

Questions to the Urology expert and their responses

Do you routinely treat patients similar to the one described in the case?

I routinely manage men with locally advanced prostate cancer with surgery (i.e. RALP) similar to the case described above.

Have you ever had a patient develop the outcome described in the case?

I have not experienced a bowel perforation in any of the RALP I've performed.

Should the surgeon have checked for leakage prior to closing?

The generally accepted protocol in confirming bowel integrity is to carefully inspect the intra-abdominal contents that are in close proximity to the site where the pneumoperitoneum is established and where the ports are placed. Also, if there is any dissection of bowel performed in the procedure, that segment of bowel needs to be thoroughly inspected.

About the expert

This board certified urologist earned his MD and completed residency training at the University of British Columbia. He later completed a fellowship in Urology at the highly regarded University of Texas MD Anderson Cancer Center. He is a member of the American Urologic Association, the Society of Urologic Oncology, and the Society of Urologic Robotic Surgery. Formerly, he worked as an Assistant Professor of Urology at the University of Miami. This expert is currently an Assistant Professor of Urology at a top University-Affiliated Medical Center.