qWhat are the safety policies for patients having a Robotic Prostatectomy?

aAs 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.

  1. 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.
  2. 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.
  3. 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.
  4. 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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