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SF019/#636 Vascular injury in robot-assisted para-aortic lymphadenectomy
  1. J Hernandez,
  2. J Acosta,
  3. L Almeciga and
  4. S Vieira
  1. Instituto Nacional de Cancerologia, Gynecology Oncology, Bogota, Colombia


First robot-assisted para-aortic lymphadenectomy performed in gynecological oncology in our country for surgical staging of cervical cancer in a patient with radiological evidence of pelvic lymph node involvement. Description of the performance of docking for para-aortic lymphadenectomy by robot-assisted surgery and the presentation of a vascular lesion during dissection of the interaortocaval nodes and its management with vascular clip. Although unplanned conversion-to-open is a rare event occurring in less than 1% of robotic-assisted cases, it is associated with worse outcomes and carries signifcant morbidity and potentially life-threatening consequences. In the setting of massive hemorrhage, timely and efective emergency undocking followed by emergency laparotomy and obtaining vascular control may be lifesaving. In this case we used a vascular clip to control the bleeding and avoid converting to an open procedure. The presence of vascular lesions during robotic-assisted surgery can occur in up to 3%, depending on the series reviewed. Keep calm and recognize the bleeding site accurately to avoid collateral damage. The surgeon should have knowledge about the different techniques that can be used to control major bleeding. Vascular clips applied properly by trained surgeons provide a safe option for vascular control injury in robotic gynecology surgery. Future research should be aimed at finding the best bleeding control technique in robotic surgery.

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