Simplifying patient positioning and port placement during robotic-assisted laparoscopic prostatectomy

Area of Science:

• Urology
• Surgical Technology
• Robotic Surgery

Background:

• Accurate patient positioning and port placement are vital for successful robotic-assisted laparoscopic radical prostatectomy (RALP).
• Challenges in achieving optimal Trendelenburg position and instrument maneuverability can impede surgical performance, particularly for novice robotic surgeons.
• These difficulties can lead to increased operative complexity and potentially impact patient outcomes.

Purpose of the Study:

• To describe a simple, cost-effective method for achieving correct patient positioning and accurate trocar placement during RALP.
• To assist surgeons, especially those new to robotic procedures, in overcoming common challenges related to patient setup.

Main Methods:

• Utilized a nautical inclinometer to precisely achieve the desired Trendelenburg position.
• Employed a plastic, double-equilateral triangle with an 8-cm border for accurate trocar placement.
• Integrated these tools into the standard RALP procedure.

Main Results:

• The described method facilitated easy and accurate attainment of the correct Trendelenburg position.
• Correct trocar placement was consistently achieved, enhancing instrument maneuverability within the abdominal cavity.
• The tools proved beneficial for surgeons early in the robotic learning curve.

Conclusions:

• A nautical inclinometer and a specific geometric triangle are effective aids for optimizing patient positioning and port placement in RALP.
• This technique simplifies critical setup steps, potentially improving the learning curve for robotic radical prostatectomy.