Abstract:

Patients with a ventriculoperitoneal shunt (VPS) are at risk for shunt infection and failure during laparoscopic and robotic abdominal surgeries due to pneumoperitoneum. Herein, we present the first-ever report of robotic surgery in two uro-oncological cases with VPS in situ. The first patient underwent robotic radical cystectomy with intracorporeal ileal conduit formation for bladder cancer, whereas the second underwent radical prostatectomy for localized prostate carcinoma. Surgeries were performed in Trendelenburg position and intra-abdominal pressure of 10-12 mm Hg. Pneumoperitoneum time was 210 and 165 min, respectively. Both patients had an uneventful intraoperative and postoperative course, without any urological or neurological sequelae at 1 and 7 years follow-up, respectively. Prolonged robotic surgeries were safely performed with less insufflation pressure in the Trendelenburg position in patients with VPS. The shunt did not affect the oncological outcomes, operative time, blood loss, or rates of conversion to open procedure during robotic surgeries.

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