60 year old had a robotic prostatectomy with bilateral pelvic node dissection and lysis of intra abdominal adhesions on 8/12/1012. He had elevated PSA, biopsy with Gleason 7 and 8 adenocarcinoma with no metastases on bone scan. He had previously had upper abdominal surgery. Following the procedure, pt was found to have a perforated small bowel which during repair surgery on 8/14/2012 was found to be adhesed to the anterior abdominal wall below the umbilicus. He has had multiple infections, abscesses and procedures since.
Is it below standard of care to perforate the small bowel during robotic prostatectomy?
MEDQUEST EXPERT OPINION:
That is absolutely a violation of the Standard of care, as he is a high risk candidate for that procedure because of prior surgery and should have discussed the high risk of perforation with patient; opting instead for the lower risk open procedure. Dr PB – Urolologist