R. Ghavamian – Complications of Laparoscopic and Robotic Urologic Surgery

Автор: R. Ghavamian
Название книги: Complications of Laparoscopic and Robotic Urologic Surgery
Формат: PDF
Жанр: Медицина
Страницы: 328
Качество: Изначально компьютерное, E-book

Written in response to the increase of minimally invasive surgery in urology, this volume familiarizes urologists with the complications of laparoscopic and robotic urologic surgery. Various procedures are described, and the management of complications associated with each procedure are discussed.

There has been an explosion in minimally invasive surgery (MIS) in urology. As
surgical subspecialists, urologists were slow to embrace minimally invasive surgery
at its inception. However, in the last decade, the interest in MIS has grown exponentially
in urology. Laparoscopic renal procedures are commonplace, and more and
more complex oncologic and reconstructive procedures are performed laparoscopically.
Much of this exponential growth has been due to the rapid dissemination
of robotic technology, specifically for prostatectomy. Soon afterward, robotic technology
was applied to other complex lower tract oncologic and reconstructive
procedures. Robotic assistance has also been applied to upper tract urologic procedures
such as pyeloplasty but its application for partial nephrectomy is more recent.
It has become apparent that robotic technology can serve as an interface between
open and laparoscopic surgery for the laparoscopically naïve surgeon. It has certainly
been shown to be so for prostatectomy, and whether the same pans out for partial
nephrectomy is yet to be seen.
As more experience is gained in MIS, more and more complex procedures are
performed laparoscopically and robotically. Contrary to logical expectation, the incidence
of complications has indeed increased with increasing experience in MIS. This
is purely a reflection of the complexity of the procedures performed rather than surgical
ineptitude. Increased surgical experience and surgeon volume with a certain
procedure can decrease perioperative morbidity. As in open surgery, complications
will be ever present in the laparoscopic management of our patients and cannot be
eradicated in all instances. They can, however, be avoided and measures can be taken
to decrease their incidence. Much of this knowledge is gained purely from surgical
experience. Certain clinical scenarios and comorbidities predispose the patient to
complications. Specific to surgical technique, certain maneuvers increase the likelihood
of intra-operative and perioperative complications and increase the likelihood
of adverse outcomes. On the contrary, certain precautions and maneuvers can serve
to prevent complications.
This textbook is intended to familiarize the modern urologist with the common
and the more eccentric complications of laparoscopic and robotic urologic surgery.
Recognized urologic experts in MIS have contributed to making this the first comprehensive
textbook specifically dedicated to complications in minimally invasive
urologic surgery. The book is divided into three specific parts. In the first part,
medical and general considerations are discussed. In the second part, generalized
discussion of common surgical complications is presented. Complications specific to
robotic surgery in general are emphasized in a separate unique chapter. The third part is dedicated to procedure-specific complications. Complications of upper tract and
lower tract laparoscopic and robotic procedures are discussed in different subsections.
In most chapters, a brief description of the procedure is provided as well as an indepth
discussion of the diagnosis and management of complications associated with
that particular procedure. In each chapter, a discussion of preventive measures is
emphasized. The last segment in this section deals with special topics such as single
port surgery, ablative procedures, and pediatric laparoscopy. Finally, a comprehensive
chapter on medico-legal implications of laparoscopic and robotic technology is
presented.
Certain complications are common in a variety of procedures and thus are emphasized
and repeated in more than one chapter. Although an attempt is made to decrease
repetition, the organization of this book is designed to lend itself to being a userfriendly
and quick reference textbook. It also at times presents unique perspectives
of different experts within the field who address the same issues in different fashions.
The organization of each chapter is left to the discretion of the authors and ample
illustrations and images are presented when appropriate. As more urologists embrace
laparoscopy and robotics and more fellows and residents are trained in this subspecialty,
the use of this technology is sure to increasingly expand in our field. Prior
knowledge of potential complications is a valuable adjunct in their diagnosis and
management. It is my hope that this textbook serves as a useful reference for management
of complications in urologic MIS. I also believe that it can serve to educate
surgeons in certain new procedures before they actually embark on performing them.
I wish to thank all authors who have contributed to this textbook. It is my sincere
hope that the reader finds this textbook user-friendly and that it can serve as a valuable
resource for urologists who wish to incorporateMIS in their surgical armamentarium.