Specific Measures To Avoid Complications

There are several disadvantages to the robotic surgical system that may lead to complications if not taken into account. Firstly, the robot surgical system is expensive and requires a large initial and ongoing investment for the hospital. Surgeons and operating room personnel must both be trained to use the system safely and efficiently. This also includes care and storage of the robot device.

If personnel are not appropriately trained and careful when setting up and taking down the device, complications could theoretically occur secondary to mechanical failures.

There have been no system malfunctions to date that could not be attributed to human error. Most common are instrument malfunction due to incorrect insertion or vision system problems due to incorrect calibration. External collisions of robotic arms are usually due to judgment errors in trocar placement or cart positioning.

The operating surgeon must become accustomed to the absence of haptic feedback. Complications may ensue owing to the lack of tactile sensation. Tissue damage may occur secondarily to excessive pressure or tension.

Until extensive experience is gained with the robotic surgical system, it is recommended that the novice robotic surgeon start the robotic-assisted pyeloplasty with a standard laparoscopic technique.

This will ensure familiarity of the anatomy and help to avoid any complications. Also, preoperative installation of the robot surgical system may require 30 to 60 minutes depending on personnel experience. This must always be taken into consideration when operating room times are assessed. Therefore, beginning the case as a standard laparoscopic procedure may give the operating room staff time to complete the robot surgical system setup.

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