Bilateral subgaleal hematoma after a robot-assisted radical prostatectomy: an uncommon complication
DOI:
https://doi.org/10.23938/ASSN.1047Keywords:
Robot-assisted radical prostatectomy, Subgaleal hematoma, Steep TrendelenburgAbstract
Robot-assisted radical prostatectomy is a relatively recent technique. Its advantages include less invasiveness, better pain management, and reduced length of hospital stay1. The surgical time, once the learning curve is over, is about two hours.
Some of the requirements when using this technique can be challenging for the anesthesiologist. The patient must be positioned in steep Trendelenburg (> 30º), a pneumoperitoneum established, and a deep muscular blockade is desirable. This potentially helps impair homeostasis, ventilation, and cervical and cephalic venous-lymphatic drainage. The presence of increased intraocular or intracranial pressures is a contraindication for performing this technique.
Common risks of the steep Trendelenburg position, which increase with time, include intraoperative hypotension, and soft-tissue edema (tongue, eyelids, conjunctiva, and scalp); severe complications are rare.
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