Yonsei Med J.  2011 Mar;52(2):365-368. 10.3349/ymj.2011.52.2.365.

Iliac Vein Injury Due to a Damaged Hot Shearstrade mark Tip Cover During Robot Assisted Radical Prostatectomy

• Lorenzo EI
• Jeong W
• Park S
• Kim WT
• Hong SJ
• Rha KH

• KMID: 1779678
• DOI: http://doi.org/10.3349/ymj.2011.52.2.365

Abstract

We report a rare case of vascular injury secondary to a damaged Hot Shearstrade mark tip cover. Two 1 mm holes in the tip cover resulted in perforations in the obturator and external iliac veins during pelvic node dissection. Bleeding was controlled with bipolar coagulation and a 5 mm metal clip in the obturator and iliac vein, respectively. The rest of the procedure was completed uneventfully. Frequent integrity assessment of this accessory is necessary. Its function is important in order to carry out safe dissection in proximity to delicate structures. When injuries arise from areas not directly involved in the dissection, immediate inspection of the instruments should be mandatory.

Keyword

Hot shears; instrument malfunction; robot assisted radical prostatectomy; Da Vinci prostatectomy

MeSH Terms

Humans
Iliac Vein/*injuries
Male
Middle Aged
Prostatectomy/*adverse effects/instrumentation/methods
Prostatic Neoplasms/surgery
Robotics/instrumentation

Figure

• 

  Fig. 1 (A) Obturator Vein Injury. Note the stream of blood from the obturator vein which noticed without apparent trauma to the vein (white arrow). (B) Controlled obturator vein bleeding. PreCise™ bipolar forceps was used to grasp the area of bleeding followed by bipolar coagulation. PBF, PreCise Bipolar Forceps; HS, Hot Shears; OV, obturator vein.

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  Fig. 2 (A) Injured External Iliac Vein. During dissection near the obturator nerve, a stream of blood was noted coming from the external iliac vein (white arrow). (B) Clipped External Iliac Vein. The iliac vein was grasped with the bipolar forceps close to the bleeding point, and a metal clip was applied tangentially. EIV, external iliac vein; ON, obturator nerve.

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  Fig. 3 Hot Shears with Tip Cover™. Inset: Perforations on Tip Cover accessory (black arrows).

Reference

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