TY - JOUR
T1 - Robotic instruments outside the surgical field can cause problems
T2 - A case of critical bleeding during robotic distal pancreatectomy
AU - Uchida, Yuichiro
AU - Takahara, Takeshi
AU - Mii, Satoshi
AU - Mizumoto, Takuya
AU - Iwama, Hideaki
AU - Kojima, Masayuki
AU - Kato, Yutaro
AU - Uyama, Ichiro
AU - Suda, Koichi
N1 - Funding Information:
Yuichiro Uchida and Ichiro Uyama wrote the manuscript. Takeshi Takahara, Satoshi Mii, Takuya Mizumoto, Hideaki Iwama, Masayuki Kojima, Yutaro Kato performed critical revision of the manuscript. Koichi Suda supervised this study. This study was not funded. Koichi Suda has no commercial association or financial involvement that might be construed as a conflict of interest in connection with the submitted article. Koichi Suda has been funded by Sysmex, Co., in relation to the Collaborative Laboratory for Research and Development in Advanced Surgical Intelligence, Fujita Health University, outside of the submitted work. Ichiro Uyama has received consulting fee and payment for lectures from Intuitive Surgical and Medicaroid. Ichiro Uyama is a member of the advisory board of Intuitive Surgical and Medtronic. Yutaro Kato has received payment from Intuitive Surgical for lectures.
Publisher Copyright:
© 2023 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.
PY - 2023/7
Y1 - 2023/7
N2 - Robotic surgery has technical advantages including high optical magnification and articulation of forceps. However, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. A case of severe intraoperative bleeding from the splenic artery during robotic distal pancreatectomy is presented, with a video. A man in his 80s with a cystic tumor located at the pancreatic tail underwent robotic distal pancreatectomy. During mobilization of the pancreatic tail by an inferior approach, the root of the splenic artery was injured by the joints of the robotic instruments located outside the surgical field and the bleeding became uncontrollable under the robotic operation. It is important to always be aware of what the forceps are in contact with outside the surgical field. While dissecting the left subdiaphragmatic area in robotic distal pancreatectomy, the root area of splenic artery tends to be outside the surgical field. More attention should be paid to the positional relationship between the forceps trajectory and the major blood vessels by checking the surgical field from a distant view on a regular basis.
AB - Robotic surgery has technical advantages including high optical magnification and articulation of forceps. However, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. A case of severe intraoperative bleeding from the splenic artery during robotic distal pancreatectomy is presented, with a video. A man in his 80s with a cystic tumor located at the pancreatic tail underwent robotic distal pancreatectomy. During mobilization of the pancreatic tail by an inferior approach, the root of the splenic artery was injured by the joints of the robotic instruments located outside the surgical field and the bleeding became uncontrollable under the robotic operation. It is important to always be aware of what the forceps are in contact with outside the surgical field. While dissecting the left subdiaphragmatic area in robotic distal pancreatectomy, the root area of splenic artery tends to be outside the surgical field. More attention should be paid to the positional relationship between the forceps trajectory and the major blood vessels by checking the surgical field from a distant view on a regular basis.
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U2 - 10.1111/ases.13193
DO - 10.1111/ases.13193
M3 - Article
C2 - 37150833
AN - SCOPUS:85158098212
SN - 1758-5902
VL - 16
SP - 588
EP - 590
JO - Asian journal of endoscopic surgery
JF - Asian journal of endoscopic surgery
IS - 3
ER -