Risk of optic nerve injury after prolonged Trendelenburg's position Postoperative loss of vision due to acute ischaemic optic nerve injury is a rare complication following pelvic surgery. A steep Trendelenburg's position of the patient, high intraabdominal pressure and a long operative time in Trendelenburg's position are recognised risk factors associated with robot-assisted pelvic surgery. This manuscript presents the underlying pathophysiologic mechanism. Practical tips and tricks for prevention are discussed.