Secure patient positioning using Badillo/Trendelenburg restraint strap during robotic surgery

Area of Science:

• Robotic Surgery
• Surgical Positioning
• Patient Safety

Background:

• Steep Trendelenburg position is essential for pelvic exposure in robotic urologic and gynecologic procedures.
• Maintaining stable patient positioning is critical to prevent intraoperative movement and ensure surgical success.

Purpose of the Study:

• To evaluate the safety and effectiveness of the reusable Badillo/Trendelenburg restraint system during robotic-assisted radical prostatectomy.
• To assess the degree of patient movement and the incidence of associated injuries when using this restraint.

Main Methods:

• The Badillo/Trendelenburg restraint, a Class I FDA-registered device, was used in 1,200 consecutive robotic-assisted radical prostatectomy cases.
• Patient positioning was assessed by marking the operating table relative to the patient's shoulder at the beginning and end of each procedure.
• Postoperative physical examinations and patient questionnaires were conducted to identify any shoulder or nerve injuries.

Main Results:

• The restraint system effectively prevented significant patient movement, with a maximum observed displacement of only 1 cm.
• No instances of shoulder or brachial plexus injury were reported among the 1,200 patients evaluated.
• The device demonstrated consistent performance across two institutions under a single surgeon's practice.

Conclusions:

• The Badillo/Trendelenburg restraint is a secure, reliable, and safe method for maintaining patient position during robotic surgery requiring steep Trendelenburg tilt.
• This system minimizes intraoperative patient movement, contributing to enhanced surgical safety in complex pelvic procedures.