Trendelenburg position in gynecologic robotic-assisted surgery

Area of Science:

• Minimally Invasive Surgery
• Gynecologic Oncology
• Robotic Surgery

Background:

• Steep Trendelenburg positioning is a common practice in robotic-assisted gynecologic surgery.
• The necessity of this position for benign indications has not been thoroughly evaluated.

Purpose of the Study:

• To assess the requirement for routine steep Trendelenburg patient positioning in robotic-assisted gynecologic surgery for benign conditions.
• To evaluate surgical outcomes without steep Trendelenburg.

Main Methods:

• A descriptive study was conducted at a university-affiliated community hospital.
• Twenty women underwent robotic-assisted gynecologic surgery for benign indications.
• Procedures included hysterectomy, myomectomy, and sacrocolpopexy, with surgeons blinded to the degree of Trendelenburg used.

Main Results:

• All procedures were successfully completed without conversion to laparotomy.
• No perioperative complications were observed, and all patients were discharged within 24 hours.
• The mean Trendelenburg position used was 16.4 degrees, with a mean BMI of 28.5.

Conclusions:

• Robotic-assisted gynecologic surgery for benign conditions can be performed effectively without steep Trendelenburg positioning.
• The routine use of steep Trendelenburg in these procedures should be reconsidered.