A Multicentre National Audit on Compartment Syndrome

1. No. 011 A Multicentre National Audit on Compartment Syndrome During Robotic-assisted Radical Prostatectomy: Prevalence and Risk Factors in the UK Conrad V Bishop1, Simon Pridgeon2 and Jim Adshead3 1Guy’s and St Thomas’ Hospitals, 2University College London Hospital, 3Lister Hospital, UK Posters Proudly Supported by: • Results • 17 of 23 UK robotic institutions chose to participate in this study • 3110 RARPs were performed by these centres over a seven year period • Nine cases of LLCS were reported from 7 of 17 centres • Seven of these cases required fasciotomy • There were no amputations or deaths • The overall prevalence in the study population is 0.29% • Introduction • Lower limb compartment syndrome (LLCS) is a rare but devastating complication of surgery in the lithotomy position (1) • LLCS may cause disfigurement, permanent disability or be fatal • The prevalence of LLCS in robot-assisted radical prostatectomy (RARP) is unknown as the world literature is limited to case reports (2,3) • Aims • Our primary aim is to evaluate the prevalence of LLCS in the UK robotic prostatectomy population • A secondary aim is to identify any associated risk factors which may contribute to LLCS • Further to this, we aim to make recommendations to minimise the risk of this complication TABLE 1. Identified risk factors for LLCS • Methods • A nationwide, multicentre audit was undertaken • All 23 robotic institutions in the NHS were invited to participate. • Data was collected anonymously to encourage full disclosure • Data included details of any cases of LLCS • Cases of LLCS were analysed to identify underlying risk factors TABLE 2. Centre volume and cases of LLCS * denotes 2 cases at a single institution • Conclusions • LLCS is rare with a prevalence of 0.29% • Long operation times and inexperience appear to be dominant surgical risk factors • Obesity and peripheral vascular disease are patient risk factors • Active mentorship should be employed to keep case times <4 hours • Case selection is important, especially early in the learning curve • All surgeons should have an awareness of LLCS as a potential serious complication of robotic surgery References Mumtaz FH, Chew H, Gelister JS. Lower limb compartment syndrome associated with the lithotomy position: concepts and perspectives for the urologist. BJU Int2002; 90: 792-9. Rosevear HM, Lightfoot AJ, Zahs M, Waxman SW, Winfield HN. Lessons learned from a case of calf compartment syndrome after robot-assisted laparoscopic prostatectomy. J Endourol2010; 10: 1597-601. Raman SR, Jamil Z. Well leg compartment syndrome after robotic prostatectomy: a word of caution. J Robotic Surg2009; 3: 105-7.