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As Director of Minimally Invasive & Robotic Surgery, Dr. Kaynan
has instituted several policies at MMH to enhance the safety of
daVinci Prostatectomy for patients having this procedure.
Most institutions do not require these safety measures of
their surgeons.
- Patients undergo preoperative cystoscopy (look in the
bladder) in order to identify the internal architecture of the
prostate gland and location of the ureters relative to the
bladder neck - knowledge of the location of the ureters prior
to surgery may help prevent their injury.
- Patients receive Indigo Carmine intravenously during
surgery to assist with identification of the ureters during
reconstruction of the urinary tract, again to help prevent
injury to the ureters.
- Patients undergo a bowel prep the day before surgery such
that in the unlikely event of an injury to the rectum or
bowels, the injury may be repaired immediately and safely.
- Patients undergo a rectal insufflation test after the
prostate has been removed (while still under anesthesia), even
if no injury is suspected, in order to verify that the rectum
is intact prior to exiting the operating room. An occult
injury, if missed, can have tragic consequences; whereas
proper repair of this unlikely problem is usually simple and
typically without consequence.
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