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Case Report: Da Vinci Robot Prostatectomy and Nerve Damage

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June 18, 2013 — According to a report published by the Expert Institute, a 65 year-old man suffered severe nerve damage after undergoing prostate surgery with the Da Vinci Surgical Robot. The report is concerning because more than 85% of all prostatectomies in the United States are performed with a surgical robot. Unfortunately, as the popularity of this procedure has grown, so has the number of case reports involving nerve damage, burns, electrocutions, and surgeon errors.

The man in the case report underwent a prostatectomy (surgical removal of the prostate gland, usually to treat prostate cancer). He was placed in the lithotomy position (on his back with knees bent and feet secured in stirrups). The surgical staff secured his shoulders, arms, and head with braces and straps. Then he was tilted backward into the Trendelenburg position, with his hips at a higher elevation than his head.

Over the next six hours, the patient remained in this position while his surgeon struggled to locate the vas deferens and the seminal vesicles. Another surgeon was called in to assist and complete the procedure. Afterward, nurses noticed that he had severe swelling in his face and head. He also had blisters where the straps secured his arms due to a blood pressure cuff that was left in the contracted position on his arm.

The patient complained of persistent numbness, tingling, and aching sensations in his arms. A neurological exam found evidence of severe nerve damage. The patient was referred to a hand doctor for additional surgery. Despite multiple surgeries, the man received only slight improvements to symptoms of nerve damage.

The report highlights concerns about surgeon error due to inadequate training with the Da Vinci Surgical Robot. Unlike traditional surgery, in which a doctor is presented with tactile feedback, surgeons using a robot are completely removed from the patient and must operate using joysticks, cameras, and four robotic arms.

The U.S. Food and Drug Administration (FDA) is now investigating a 34% spike in adverse event reports associated with robot surgery between 2011 and 2012. Many of the injuries were caused by surgeon errors or malfunctioning equipment.

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