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

Steep Trendelenburg position is routine during robotic urologic and gynecologic surgery in order to optimize exposure of the pelvis. This position requires that the patient be properly secured as to avoid any movement during the procedure. We analyzed the safety and tolerability of a reusable strap with disposable cushions used during robotic assisted radical prostatectomy. The Badillo/Trendelenburg restraint is a harness which is placed on the table prior to patient transfer. The restraint is a Class I FDA-registered device (Pintler Medical, Seattle, WA). Patients were marked at the beginning and end of the case to determine if any movement had occurred. The Badillo/Trendelenburg restraint was employed in 1,200 consecutive RARP cases. The restraint was used by a single surgeon at two institutions. The operating table was marked from edge of the patients shoulder to the end of the head of table at the beginning and end of the case to determine if any movement had occurred. Maximum movement observed was 1 cm. All patients were questioned and a physical examination were done in the post operative period for any shoulder or nerve injury. No reports of shoulder or brachial injury. For patients undergoing robotic surgery with steep Trendelenburg position the Badillo/Trendelenburg restraint provides a secure, reliable and safe means of maintaining proper position without any patient movement.