Arteriovenous fistula after robot-assisted laparoscopic prostatectomy: A rare case report

Introduction: Arteriovenous fistula after radical prostatectomy is very uncommon. We report a rare case of pseudoaneurysm associated with arteriovenous fistula following robot-assisted laparoscopic prostatectomy.

Case presentation: A 67-year-old man diagnosed with prostatic adenocarcinoma underwent robot-assisted laparoscopic prostatectomy. He had a fever and lower abdominal pain with sign of peritoneal irritation, and his blood hemoglobin level dropped on postoperative day 11. Hemorrhage in the pelvic space with extravascular leakage was detected by contrast-enhanced computed tomography, and he underwent emergency angiography. An aneurysmal dilatation with early venous drainage was confirmed in a branch of the left internal iliac artery, and we diagnosed arteriovenous fistula. Transcatheter arterial embolization was performed, and the aneurysmal structure subsequently disappeared.

Conclusion: Arteriovenous fistula may occur as a complication of robot-assisted laparoscopic prostatectomy. Transcatheter arterial embolization appears to be a useful and minimally invasive treatment.

Keywords: arteriovenous fistula; prostatectomy; pseudoaneurysm; robotic surgery; transcatheter arterial embolization.