Abstract

RUBIO-BAINES, Iñigo et al. Bilateral subgaleal hematoma after a robot-assisted radical prostatectomy: an uncommon complication. Anales Sis San Navarra [online]. 2023, vol.46, n.2, e1047.  Epub Feb 12, 2024. ISSN 1137-6627.  https://dx.doi.org/10.23938/assn.1047.

Robot-assisted radical prostatectomy is a relatively recent technique. Its advantages include less invasiveness and better pain management, but has specific anesthesia requirements, such as steep Trendelenburg position and pneumoperitoneum. Mild complications are common, e.g., transient hypotension or soft tissue edema.

We present a case of a 62-year old male who developed subgaleal hematoma associated with transient neurologic impairment after surgery. Jugular vein insufficiency was suspected as the most likely cause. The patient recovered fully.

Robot-assisted radical prostatectomy can be a challenging procedure due to the anesthesia requirements, but most complications are mild and transient. However, patients should be carefully assessed before surgery. We identified potential factors that may have led to this complication: the abnormal prolonged surgical time, the steep Trendelenburg, a non-assessed jugular vein insufficiency, and/or patient’s obesity.

Keywords : Robot-assisted radical prostatectomy; Subgaleal hematoma; Steep Trendelenburg.

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