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Ergonomic port placement in robotic colorectal surgery
Shing Wai Wong1,2, Zhen Hao Ang1,2, Jia Lin Chua3
1Department of General Surgery, Prince of Wales Hospital, Sydney, NSW, Australia.
Summary
Wider port spacing (8 cm) and oblique alignment in robotic colorectal surgery enhance manipulation angles. Oblique 8 cm spacing offers the greatest angles, crucial for optimal surgical dissection.
Area of Science:
- Minimally Invasive Surgery
- Surgical Robotics
- Colorectal Surgery
Background:
- Robotic surgery offers enhanced dexterity but optimal port configuration is key.
- Understanding port spacing and alignment impacts instrument maneuverability.
Purpose of the Study:
- To evaluate the effect of port spacing (6 cm vs. 8 cm) and alignment (oblique vs. vertical) on manipulation angles.
- To determine optimal port configurations for robotic colorectal procedures.
Main Methods:
- Analysis of abdominal CT scans from 20 patients undergoing robotic right hemicolectomy or high anterior resection.
- Calculation of manipulation angles using predefined anatomical landmarks on preoperative CT scans.
- Marking of port placements on CT scans to measure angles.
Main Results:
- An 8 cm port spacing resulted in significantly greater manipulation angles compared to 6 cm spacing for both procedures.
- Oblique port alignment generally yielded wider manipulation angles than vertical alignment.
- Vertical alignment with 6 cm spacing was less effective, except for splenic flexure dissection.
Conclusions:
- Oblique 8 cm port spacing provides the maximal manipulation angles in robotic colorectal surgery.
- This configuration is recommended for most robotic colorectal procedures to optimize instrument reach and dissection.
- Port configuration significantly influences surgical efficiency in robotic colorectal operations.
