This case involves the removal of a malignant kidney tumor on a fifty-eight-year-old male patient using the da Vinci robotic surgery system. The procedure was met with significant complications that resulted in the untimely death of the patient. The patient’s aorta was nicked during the introduction of the mechanical arms into the patient’s thoracic cavity. Upon further investigation, it was determined that there was inadequate training amongst the surgeons involved in the procedure. Several hospital employees gave statements that the hospital was more concerned with having an opportunity to utilize the new device rather than ensuring proper patient care and safety.
Question(s) For Expert Witness
- 1. What are your thoughts on da Vinci surgery and the case at hand?
Expert Witness Response E-000493
When nephron-sparing surgery is absolutely indicated (ie, solitary kidney, bilateral tumors, renal insufficiency), some of these contraindications can be overlooked, especially in the hands of highly experienced surgeons, but that doesn’t seem to be the case here as inadequate training was an issue. It should be kept in mind that the threshold to use the open approach or conversion to open should be held low in these complex scenarios. In addition, the standard relative contraindications to laparoscopic surgery (eg, significant prior abdominal surgeries, bowel obstruction) still apply to robot-assisted surgery.
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