Injury to the Spleen
- Avoidance through subtle preparation
- Therapy through robotic hemostatic measures (coagulation, hemostatics) and splenectomy as ultima ratio
Esophageal/Stomach Wall Injury
- Avoidance through subtle preparation
- Diagnostics through intraoperative blue test possible
Therapy through oversewing of the defect and covering with the cuff in the ideal case - if necessary, intraoperative endoscopic control
Pneumothorax
- due to injury to the parietal pleura during mediastinal preparation
- only significant in case of cardiopulmonary problems intraoperatively
- in stable patient initially without consequence
- in case of increasing ventilation pressure or poor oxygenation, first reduction of intra-abdominal pressure and increase of positive inspiratory pressure
- if necessary, otherwise intraoperative chest drainage. Completion of the operation robotically with drainage in place
- at the end of the OP good ventilation of the lung through manual ventilation with open trocars
Bleedings
Short gastric arteries:
- Possible complicationin transection of the short gastric arteries for gastric fundus mobilization
- Hemostasis can be demanding in case of poor exposure with strong visceral adiposity.
Diaphragmatic veins:
- In close proximity to the hiatus
- Hemostasis can also be demanding
Aorta:
- Runs behind the hiatus
- An injury is theoretically possible