Robotic Urological Surgery in the Time of COVID-19: Challenges and Solutions

Abstract

INTRODUCTION: We assess issues and challenges in the field of robotic urological surgery during the COVID-19 pandemic, and discuss current and future solutions. METHODS: We considered the relevant literature as well as clinical and surgical experience at our institution. RESULTS: A risk-benefit assessment of each patient undergoing robotic urological surgery should be performed during the COVID-19 pandemic, which is based on the urgency of the surgery, and risk of viral diseases and transmission. Preoperative testing and symptom screening are recommended to identify patients with COVID-19. Adequate personal protective equipment for the surgical team is essential to protect patients and health care workers. Although the transmission method has not yet been identified during robotic procedures, efforts should be made to minimize the risk of aerosolization. The anesthesia method should minimize aerosolization of the virus, and negative pressure rooms are strongly preferred for COVID-19 positive patients. CONCLUSIONS: Significant challenges have emerged during the COVID-19 pandemic, which also impact the field of robotic urological surgery. Perioperative practices and surgical strategies should be adapted to overcome these challenges with the aim of minimizing risk of transmission while optimizing robotic surgical outcomes. Recommendations will continue to evolve as more data become available.